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Significance of a new fluorodeoxyglucose-positive lesion on restaging positron emission tomography/computed tomography after induction therapy for non-small-cell lung cancer †

Collaud, Stéphane ; Lardinois, Didier ; Tischler, Verena ; Steinert, Hans C. ; Stahel, Rolf ; Weder, Walter

In: European Journal of Cardio-Thoracic Surgery, 2012, vol. 41, no. 3, p. 612-616

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    Titre
    • Significance of a new fluorodeoxyglucose-positive lesion on restaging positron emission tomography/computed tomography after induction therapy for non-small-cell lung cancer †
    Auteur
    • Collaud, Stéphane. Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
    • Lardinois, Didier. Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
    • Tischler, Verena. Division of Pathology, University Hospital Zurich, Zurich, Switzerland
    • Steinert, Hans C.. Division of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
    • Stahel, Rolf. Division of Oncology, University Hospital Zurich, Zurich, Switzerland
    • Weder, Walter. Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Cardio-Thoracic Surgery, 2012, vol. 41, no. 3, p. 612-616. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:291686
    Summary
    OBJECTIVES Restaging of patients with locally advanced non-small-cell lung cancer (NSCLC) is of paramount importance, since only patients with down-staging after induction therapy will benefit from surgery. In this study, we assessed the aetiology of new 18fluoro-2-deoxy-d-glucose (FDG)-positive focal abnormalities on restaging positron emission tomography/computed tomography (PET/CT) in patients with a good response after induction chemotherapy in the primary tumour and lymph nodes. METHODS Between 2004 and 2008, 31 patients with histological proven stage III NSCLC had a PET/CT prior and after induction chemotherapy. Their medical charts were retrospectively reviewed. RESULTS Restaging PET/CT revealed a new FDG-positive lesion in 6 of 31 (20%) patients. The initial clinical stage of the disease was IIIA N2 in four and IIIB T4 in two patients. The maximal standard uptake value in the primary tumour (P=0.043) and in the initially involved mediastinal nodes (P=0.068) decreased after induction treatment in all patients. The new PET/CT findings were located in an ipsilateral cervical lymph node in two patients, a contralateral mediastinal in one patient and an ipsilateral mammary internal lymph node in one patient. Two other patients had a lesion on the contralateral lung. Malignant lymph node infiltrations were excluded following fine-needle puncture, intraoperative biopsy or follow-up PET/CT. Contralateral pulmonary lesions were diagnosed as benign following mini thoracotomy and pulmonary wedge resection. CONCLUSIONS New solitary FDG-positive lesions on restaging PET/CT after induction chemotherapy for NSCLC are not rare in good responders to chemotherapy. In our experience, all these lesions were not associated with malignancy