• Sung Hwan Kim, Jong Hoon Lee, Guk Jin Lee, Songmi Jeong, Yoo-Kang Kwak, Hoon-Kyo Kim, Deog Gon Cho, Young Ha Park, Mina Yu, and Sei Chul Yoon.
• From the Department of Radiation Oncology (SHK, JHL, SMJ, YKK); Internal Medicine (HKK); Thoracic Surgery (DGC); Nuclear Medicine (YHP), St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea and Radiation Oncology (MNY, SCY); Internal Medicine (GJL), Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.
• Medicine (Baltimore). 2015 Jun 1; 94 (24): e955.

AbstractWe evaluate the correlation of clinical staging on positron emission tomography-computed tomography (PET-CT) and pathologic staging and the prognostic value of PET-CT after induction chemotherapy in patients with locally advanced nonsmall cell lung cancer (NSCLC). We analyzed 42 cases of clinical stage IIIA-N2 NSCLC who receive 2 to 4 cycles of preoperative chemotherapy with or without radiation followed by curative resection. The maximum standard uptake value (SUVmax) of the suspected lesion on PET-CT was recorded. PET-CT findings after induction chemotherapy were compared with those of initial PET-CT and pathology after surgery. The accuracy of PET-CT in restaging of the primary tumor after induction chemotherapy was 50.0%. Eighteen (42.8%) of 42 patients were underestimated ycT stage, and 3 (7.1%) of 42 patients was overestimated ycT stage by PET-CT scan. The accuracy of PET-CT in restaging of the nodal disease was 71.4%. Six (14.3%) of 42 patients were underestimated ycN stage, and 6 (14.3%) of 42 patients were overestimated ycN stage as compared with pathologic staging. The 2-year overall survival (OS) and relapse-free survival (RFS) rate were 68.5% and 40.9%, respectively. Complete responders (ycT0N0M0) on PET-CT after induction chemotherapy had a significantly longer RFS time than did incomplete responders (28.3 vs 9.1 months, P = 0.021). Complete response on PET-CT after induction chemotherapy with or without radiation was a good prognosticator for RFS in stage IIIA-N2 NSCLC patients who received surgery. However, response evaluation on PET-CT after induction chemotherapy should be interpreted with caution due to its unacceptable accuracy.

30 keywords...

hide…