| Preoperative staging of lung cancer with combined PET-CT. | |
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MedLine Citation:
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PMID: 19571281 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC. METHODS: We randomly assigned patients who were referred for preoperative staging of NSCLC to either conventional staging plus PET-CT or conventional staging alone. Patients were followed until death or for at least 12 months. The primary end point was the number of futile thoracotomies, defined as any one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause within 1 year after randomization. RESULTS: From January 2002 through February 2007, we randomly assigned 98 patients to the PET-CT group and 91 to the conventional-staging group. Mediastinoscopy was performed in 94% of the patients. After PET-CT, 38 patients were classified as having inoperable NSCLC, and after conventional staging, 18 patients were classified thus. Sixty patients in the PET-CT group and 73 in the conventional-staging group underwent thoracotomy (P=0.004). Among these thoracotomies, 21 in the PET-CT group and 38 in the conventional-staging group were futile (P=0.05). The number of justified thoracotomies and survival were similar in the two groups. CONCLUSIONS: The use of PET-CT for preoperative staging of NSCLC reduced both the total number of thoracotomies and the number of futile thoracotomies but did not affect overall mortality. (ClinicalTrials.gov number, NCT00867412.) |
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Authors:
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Barbara Fischer; Ulrik Lassen; Jann Mortensen; Søren Larsen; Annika Loft; Anne Bertelsen; Jesper Ravn; Paul Clementsen; Asbjørn Høgholm; Klaus Larsen; Torben Rasmussen; Susanne Keiding; Asger Dirksen; Oke Gerke; Birgit Skov; Ida Steffensen; Hanne Hansen; Peter Vilmann; Grete Jacobsen; Vibeke Backer; Niels Maltbaek; Jesper Pedersen; Henrik Madsen; Henrik Nielsen; Liselotte Højgaard |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The New England journal of medicine Volume: 361 ISSN: 1533-4406 ISO Abbreviation: N. Engl. J. Med. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-02 Completed Date: 2009-07-07 Revised Date: 2011-03-11 |
Medline Journal Info:
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Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: United States |
Other Details:
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Languages: eng Pagination: 32-9 Citation Subset: AIM; IM |
Copyright Information:
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2009 Massachusetts Medical Society |
Affiliation:
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Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. bjerregaard.fischer@gmail.com |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00867412 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung / diagnosis*, mortality, surgery Female Follow-Up Studies Humans Lung Neoplasms / diagnosis*, mortality, surgery Lymphatic Metastasis Male Middle Aged Neoplasm Staging / methods* Positron-Emission Tomography* Preoperative Care* Sensitivity and Specificity Thoracotomy / statistics & numerical data* Tomography, X-Ray Computed* |
| Comments/Corrections | |
Comment In:
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Ann Intern Med. 2009 Nov 17;151(10):JC5-8
[PMID:
19920266
]
N Engl J Med. 2011 Mar 10;364(10):980-1 [PMID: 21388332 ] N Engl J Med. 2009 Oct 15;361(16):1606; author reply 1608 [PMID: 19828539 ] N Engl J Med. 2009 Oct 15;361(16):1606-7; author reply 1608 [PMID: 19842246 ] N Engl J Med. 2009 Oct 15;361(16):1606; author reply 1608 [PMID: 19842245 ] N Engl J Med. 2009 Oct 15;361(16):1607; author reply 1608 [PMID: 19842248 ] N Engl J Med. 2009 Oct 15;361(16):1607; author reply 1608 [PMID: 19842247 ] |
Erratum In:
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N Engl J Med. 2011 Mar 10;364(10):982 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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