| Objectives: To demonstrate: a) The accuracy of PET/CT scan v/s CT scan and PET scan and b) The post-recurrence survival rate in patients operated for NSCLCMethods: A retrospective study was performed on 44 patients. We collected from the First Affiliated Hospital of Dalian medical University and the PET scan department. SPSS 20 software package was used to analyze the statistical data.Results: A total of 77 patients were enrolled in the study between May 2010 and August 2012 but according to our inclusion criteria only 44 were analyzed in our study(n=44) whereby there were 26 males(59.1%) and 18 females(40.9 %) ranging from 51 to 81 years old with a mean age of 65.75 years. Smoking history showed 63.6% were smokers Adenocarcinoma was the most frequently encountered histopathological finding with 21 out 44 patients(47.7%). Compared to the histology results, PET/CT more accurately staged disease in all 44 patients(kappa = 0.83) than CT(kappa = 0.694) and PET(kappa = 0.614). Concordance for staging the lymph node involvement(N) between PET/CT and histological examination was good(kappa = 0.75, < 0.001). Agreement between PET and histological examination was moderate(kappa = 0.57, < 0.001). Staging accuracy was calculated for the three approaches. PET/CT showed a sensitivity of 94%(95% CI, 86.1–98.3), specificity of 82%(95% CI, 72.2–93.3), positive predictive value(PPV) of 80%, and negative predictive value(NPV) of 95%. CT alone showed a sensitivity of 76%(95% CI, 63.0–81.0), specificity of 72%(95% CI, 63.0–81.0), PPV of 68%, and NPV of 86%. PET alone showed a sensitivity of 60%(95% CI, 51.0–69.0), specificity of 50%(95% CI, 40.0–60.0), PPV of 53%, and NPV of 66%. Only 10 patients(22.7%) discovered the recurrence via symptoms, and 7 patients(15.9%) without symptoms. The mean recurrence-free interval(RFI) was 15.4 ± 10.7 months, and 8 patients(47.1%) had an RFI of 12 months or less, while 9 patients(52.9%) had an RFI of longer than 12 months. The 1 and 3 year overall survival(OS) rates were 88% and 53%, respectively There was no statistically significant difference between locoregional recurrence and distant metastasis(P = 0.831). Prognostic factors for significantly poor post-recurrence OS(overall survival) were identified by the univariate analysis as follows: presence of symptoms(P = 0.01), recurrence within 12 months of surgery(P = 0.02).Conclusion: The effect of PET-CT on clinical staging of NSCLC was significant. Whole-body PET-CT appears to be a precise, highly efficient and non-invasive method for T and N staging in patients with Lung cancer, due to its increased specificity, sensitivity and accuracy compared to CT, the most used method for staging evaluation. Therefore, PET-CT is an important compensatory staging measure. Multivariate analysis revealed that the RFI of 12 months or longer and the good response at initial treatment were the significant predictors for better recurrence survival. |
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