Chest
Clinical Investigations: CancerMediastinal Lymph Node Staging With FDG-PET Scan in Patients With Potentially Operable Non-small Cell Lung Cancer: A Prospective Analysis of 50 Cases
Section snippets
Materials and Methods
Patients were eligible if they had suspected or biopsy specimen-proved NSCLC, potentially operable after standard staging for distant metastases.26 Exclusion criteria were diabetes mellitus, treatment with oral corticosteroids, ischemic cardiomyopathy, direct mediastinal invasion by the primary tumor, and obvious bulky mediastinal adenopathies. We tried to include all eligible patients, although this was not always possible due to schedule limitations in admission to the hospital, or in the
Results
The records of 50 patients, treated between September 1995 and April 1996, were analyzed prospectively. Their mean age was 65 years (range, 40 to 83 years). There were 32 squamous cell tumors, 10 adenocarcinomas, and 8 large cell carcinomas. Thirty-one tumors were localized in the upper lobes (18 right, 13 left) and 15 were localized in the lower lobes (10 right, 5 left). Two tumors were in the right intermediate bronchus, and one in the right middle lobe and left main stem bronchus each.
Discussion
The optimal treatment of patients with potentially operable NSCLC depends on the preoperative mediastinal stage. Resection is worthwhile in patients with so-called “unforeseen N2,” found at thoracotomy after normal preoperative mediastinoscopy.1, 2, 3, 4, 5, 6 Patients with a preoperative abnormal mediastinoscopy are preferably entered in a multimodality treatment, including induction chemotherapy and surgery or radiotherapy.29, 30
Surgical techniques, either cervical mediastinoscopy31 or
APPENDIX
The Leuven Lung Cancer Group consists of pulmonary oncologists (J. Vansteenkiste, K. Nackaerts, M. Demedts), thoracic surgeons (G. Deneffe, P. De Leyn, T. Lerut), radiation oncologists (J. Menten, L. Van Uytsel, E. Van der Schueren), and other coworkers from the Departments of Pulmonology (B. Buyse, M. Decamer, M. Delcroix, A. Vandeneeckhout, G. Verleden), Thoracic Surgery (D. Van Raemdonck, W. Coosemans), Radiation Oncology (K. Haustermans, P. Lambin, W. Van den Bogaert, E. Van Limbergen),
ACKNOWLEDGMENT
The authors thank G. Bormans for the supply of the FDG, and S. Vleugels and W. Costermans for their dedicated assistance in PET image acquisition and processing.
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For a full listing of the members of the Leuven Lung Cancer Group, see the Appendix