| Mediastinal lymph node staging by means of positron emission tomography is less sensitive in elderly patients with non-small-cell lung cancer. | |
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MedLine Citation:
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PMID: 18282357 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: We sought to identify the impact of age on the sensitivity and specificity of integrated positron emission tomography/computed tomography (PET-CT; CT) on mediastinal lymph node staging of patients with non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: We conducted a retrospective review of 206 consecutive patients with histologically proven NSCLC who underwent resection and/or mediastinoscopy in our center between September 2004 and January 2007. All of these patients had preoperative staging with integrated PET-CT as an adjunct to chest CT before resection and/or mediastinoscopy. Diabetic patients and patients who received neoadjuvant chemotherapy were excluded. The pathologic results of all of these cases were reviewed and correlated with those on CT and integrated PET-CT. RESULTS: The sensitivity and positive predictive values (PPV) of PET-CT in mediastinal nodal staging were significantly lower in elderly patients (age>or=65 years; sensitivity, 42%; PPV, 66%) than in younger patients (age<65 years; sensitivity, 52%; PPV, 74%). Specificity and negative predictive values were similar in both groups. CONCLUSION: PET-CT staging of the mediastinum is less sensitive in elderly patients with NSCLC who have a lower PPV. Positive mediastinal uptake on PET-CT should be verified by mediastinoscopy, irrespective of age. Elderly patients with positive mediastinal uptake should not be refuted a curative intent surgical resection on the basis of positive mediastinal uptake alone. |
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Authors:
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Nael Al-Sarraf; Kathy Gately; Julie Lucey; Lorraine Wilson; Eillish McGovern; Vincent Young |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical lung cancer Volume: 9 ISSN: 1525-7304 ISO Abbreviation: Clin Lung Cancer Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-02-19 Completed Date: 2008-04-29 Revised Date: 2008-12-12 |
Medline Journal Info:
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Nlm Unique ID: 100893225 Medline TA: Clin Lung Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 39-43 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic Surgery, St. James's Hospital, Dublin, Ireland. trinityq8@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung / pathology*, radionuclide imaging, surgery Female Fluorodeoxyglucose F18 / diagnostic use Humans Lung Neoplasms / pathology*, radionuclide imaging, surgery Lymphatic Metastasis Male Mediastinoscopy Middle Aged Neoplasm Staging Positron-Emission Tomography / methods* Retrospective Studies Sensitivity and Specificity Tomography, X-Ray Computed |
| Chemical | |
Reg. No./Substance:
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63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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