JTCS Speed Up Your Browser
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Robert James Cerfolio
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bryant, A. S.
Right arrow Articles by Cerfolio, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bryant, A. S.
Right arrow Articles by Cerfolio, R. J.
Related Collections
Right arrowRelated Article

J Thorac Cardiovasc Surg 2006;132:1363-1368
© 2006 The American Association for Thoracic Surgery

General Thoracic Surgery

The clinical stage of non–small cell lung cancer as assessed by means of fluorodeoxyglucose–positron emission tomographic/computed tomographic scanning is less accurate in cigarette smokers

Ayesha S. Bryant, MSPH, MDa, Robert James Cerfolio, MD, FACS, FCCPb,*

a Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, Ala.
b Division of Cardio-Thoracic Surgery, Department of Surgery, University of Alabama at Birmingham (UAB), Birmingham, Ala.

Read at the Eighty-sixth Annual Meeting of The American Association for Thoracic Surgery, Philadelphia, Pa, April 29-May 3, 2006.

Received for publication May 8, 2006; revisions received June 28, 2006; accepted for publication July 12, 2006.

* Address for reprints: Robert J. Cerfolio, MD, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, 1900 University Blvd, THT 712, Birmingham, AL 35294 (Email: Robert.cerfolio{at}ccc.uab.edu).

OBJECTIVE: The treatment of non–small cell lung cancer depends on the stage, and this is clinically best determined by using fluorodeoxyglucose–positron emission tomography/computed tomography. We evaluated the effect smoking has on the accuracy of this test.

METHODS: We performed a prospective cohort study evaluating the accuracy of clinical stage compared with pathologic stage between cigarette smokers and nonsmokers with non–small cell lung cancer. All patients were assigned a clinical TNM stage after fluorodeoxyglucose–positron emission tomographic/computed tomographic scanning and then underwent meticulously pathologic TNM staging. If N2, N3, or M1 negative, patients underwent thoracotomy with complete thoracic lymphadenectomy. The clinical and pathologic stages were compared.

RESULTS: There were 246 patients: 52 never smoked (NS group), 112 quit at least 1 month before fluorodeoxyglucose–positron emission tomography/computed tomography (Q group), and 82 were still smokers (S group). The 3 groups were similar for stage and histology. The overall accuracy was 83%, 80%, and 64% for the NS, Q, and S groups, respectively (P = .03). The accuracy for the T status was 88%, 84%, and 86%; accuracy for the N2 lymph nodes was 96%, 75%, and 72%; and accuracy for the N1 lymph nodes was 92%, 78%, and 80%, respectively, favoring the NS group. The greater the pack-year history, the greater the N2 inaccuracy (P = .04). Multivariate analysis showed that status of smoking (P = .026) and maxSUV value (P = .014) were independent predictors of fluorodeoxyglucose–positron emission tomography/computed tomography accuracy.

CONCLUSIONS: Patients with non–small cell lung cancer who continue to smoke at the time of their fluorodeoxyglucose–positron emission tomographic/computed tomographic scan have less accurate clinical staging compared with those who stopped 1 month before or who never smoked. As the pack-years increase, the accuracy for the N2 nodes decrease. Nonsmokers have the most accurate clinical staging.

Abbreviations and Acronyms CT = computed tomography; FDG = fluorodeoxyglucose; FDG-PET/CT = fluorodeoxyglucose–positron emission tomographic/computed tomographic; MaxSUV = maximum standardized uptake value; NSCLC = non–small cell lung cancer; PET = positron emission tomography; ROI = region of interest


Related Article

Discussion
J. Thorac. Cardiovasc. Surg. 2006 132: 1368. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 ChestHome page
A. Bryant and R. J. Cerfolio
Differences in Epidemiology, Histology, and Survival Between Cigarette Smokers and Never-Smokers Who Develop Non-small Cell Lung Cancer
Chest, July 1, 2007; 132(1): 185 - 192.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2006 by The American Association for Thoracic Surgery.