Omission of staging PET/CT linked to reduced survival in stage
III non-small cell lung cancer: insights from the LUCAS project
real-world data

J 2024

Omission of staging PET/CT linked to reduced survival in stage III non-small cell lung cancer: insights from the LUCAS project real-world data

KRAKOROVA, Gabriela, Petr DOMECKY, Jiri BLAZEK, Milos PESEK, Ondřej VENCLÍČEK et. al.

Basic information

Original name

Omission of staging PET/CT linked to reduced survival in stage III non-small cell lung cancer: insights from the LUCAS project real-world data

Authors

KRAKOROVA, Gabriela (203 Czech Republic), Petr DOMECKY (203 Czech Republic), Jiri BLAZEK (203 Czech Republic), Milos PESEK (203 Czech Republic), Ondřej VENCLÍČEK (203 Czech Republic, belonging to the institution), Libor HAVEL (203 Czech Republic), Michal HRNCIARIK (203 Czech Republic), Jana KREJCI (203 Czech Republic), Andrea MULLEROVA (203 Czech Republic), Miloslav MAREL (203 Czech Republic), Jaroslav DUBA (203 Czech Republic) and Martin SVATON (203 Czech Republic)

Edition

TRANSLATIONAL LUNG CANCER RESEARCH, PEOPLES R CHINA, AME PUBL CO, 2024, 2218-6751

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30203 Respiratory systems

Country of publisher

China

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.000 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.21037/tlcr-24-108

UT WoS

001304774000004

Keywords in English

Lung cancer; staging; positron emission tomography and computed tomography (PET/CT); survival; stage III

Abstract

V originále

Background: Stage III non-small cell lung cancer (NSCLC) is a highly heterogeneous stage due to its subgroups (IIIA-IIIC) comprising both resectable and unresectable tumors. Accurate determination of the extent of the disease is essential for excluding stage IV and choosing the optimal treatment regimen. Whole body positron emission tomography and computed tomography scan (PET/CT) is recommended as an initial staging imaging in locally advanced NSCLC. Despite international guidelines for NSCLC diagnosis and treatment, they are not always adhered to due to various reasons. Even in such a groundbreaking study, the phase 3 trial PACIFIC investigating the efficacy of durvalumab as consolidation therapy in patients with stage III NSCLC PET/CT was not mandatory. With the premise that whole body PET/CT of the trunk is essential for diagnosing stage III NSCLC, we performed a retrospective study evaluating the relationship of the use of PET/CT versus conventional staging with CT of the chest and abdomen, in terms of survival. Methods: This retrospective study of stage III NSCLC patients used the Czech lung cancer registry LUCAS, which was established in June 2018. As of the data export (up to February 9, 2022), a total of 703 patients were eligible for the analysis. Overall survival (OS) was compared using Kaplan-Meier analysis and a Cox regression model. Continuous variables were tested using the Mann-Whitney test, and categorical variables using the Pearson's Chi-square or Fisher's exact test. Results: A total of 703 patients were included in the cohort with an average age of 69 years. PET/CT was performed on 354 patients, and conventional staging using chest and abdominal CT on 349 patients. The median OS among patients with PET/CT was 20.9 months [95% confidence interval (CI): 18.1-23.7], and it was statistically significantly higher (P<0.001) than among patients without PET/CT, where the median OS was 9.0 months (95% CI: 7.3-10.6). The observed effect of PET/CT was also statistically significant when comparing individual stages (IIIA, IIIB, IIIC). The multivariate Cox model confirmed the use of PET/CT as an independent prognostic factor. The most common reason for omission of PET/CT was the local or time unavailability of the examination. Conclusions: Omission of PET/CT can mean a significant decrement in survival for the patients in stage III NSCLC, likely due to poor staging and suboptimal treatment. Routine use of PET/CT is strictly recommended for the optimal management of stage III NSCLC patients even outside the high-income countries.

Citovat

KRAKOROVA, Gabriela, Petr DOMECKY, Jiri BLAZEK, Milos PESEK, Ondřej VENCLÍČEK, Libor HAVEL, Michal HRNCIARIK, Jana KREJCI, Andrea MULLEROVA, Miloslav MAREL, Jaroslav DUBA and Martin SVATON. Omission of staging PET/CT linked to reduced survival in stage III non-small cell lung cancer: insights from the LUCAS project real-world data. TRANSLATIONAL LUNG CANCER RESEARCH. PEOPLES R CHINA: AME PUBL CO, 2024, vol. 13, No 7, p. 1-13. ISSN 2218-6751. Available from: https://dx.doi.org/10.21037/tlcr-24-108.

@article{2439118,
   author = {Krakorova, Gabriela and Domecky, Petr and Blazek, Jiri and Pesek, Milos and Venclíček, Ondřej and Havel, Libor and Hrnciarik, Michal and Krejci, Jana and Mullerova, Andrea and Marel, Miloslav and Duba, Jaroslav and Svaton, Martin},
   article_location = {PEOPLES R CHINA},
   article_number = {7},
   doi = {http://dx.doi.org/10.21037/tlcr-24-108},
   keywords = {Lung cancer; staging; positron emission tomography and computed tomography (PET/CT); survival; stage III},
   language = {eng},
   issn = {2218-6751},
   journal = {TRANSLATIONAL LUNG CANCER RESEARCH},
   title = {Omission of staging PET/CT linked to reduced survival in stage III non-small cell lung cancer: insights from the LUCAS project real-world data},
   url = {https://tlcr.amegroups.org/article/view/88272/html},
   volume = {13},
   year = {2024}
}

TY  - JOUR
ID  - 2439118
AU  - Krakorova, Gabriela - Domecky, Petr - Blazek, Jiri - Pesek, Milos - Venclíček, Ondřej - Havel, Libor - Hrnciarik, Michal - Krejci, Jana - Mullerova, Andrea - Marel, Miloslav - Duba, Jaroslav - Svaton, Martin
PY  - 2024
TI  - Omission of staging PET/CT linked to reduced survival in stage III non-small cell lung cancer: insights from the LUCAS project real-world data
JF  - TRANSLATIONAL LUNG CANCER RESEARCH
VL  - 13
IS  - 7
SP  - 1-13
EP  - 1-13
PB  - AME PUBL CO
SN  - 22186751
KW  - Lung cancer
KW  - staging
KW  - positron emission tomography and computed tomography (PET/CT)
KW  - survival
KW  - stage III
UR  - https://tlcr.amegroups.org/article/view/88272/html
N2  - Background: Stage III non-small cell lung cancer (NSCLC) is a highly heterogeneous stage due to its subgroups (IIIA-IIIC) comprising both resectable and unresectable tumors. Accurate determination of the extent of the disease is essential for excluding stage IV and choosing the optimal treatment regimen. Whole body positron emission tomography and computed tomography scan (PET/CT) is recommended as an initial staging imaging in locally advanced NSCLC. Despite international guidelines for NSCLC diagnosis and treatment, they are not always adhered to due to various reasons. Even in such a groundbreaking study, the phase 3 trial PACIFIC investigating the efficacy of durvalumab as consolidation therapy in patients with stage III NSCLC PET/CT was not mandatory. With the premise that whole body PET/CT of the trunk is essential for diagnosing stage III NSCLC, we performed a retrospective study evaluating the relationship of the use of PET/CT versus conventional staging with CT of the chest and abdomen, in terms of survival. Methods: This retrospective study of stage III NSCLC patients used the Czech lung cancer registry LUCAS, which was established in June 2018. As of the data export (up to February 9, 2022), a total of 703 patients were eligible for the analysis. Overall survival (OS) was compared using Kaplan-Meier analysis and a Cox regression model. Continuous variables were tested using the Mann-Whitney test, and categorical variables using the Pearson's Chi-square or Fisher's exact test. Results: A total of 703 patients were included in the cohort with an average age of 69 years. PET/CT was performed on 354 patients, and conventional staging using chest and abdominal CT on 349 patients. The median OS among patients with PET/CT was 20.9 months [95% confidence interval (CI): 18.1-23.7], and it was statistically significantly higher (P<0.001) than among patients without PET/CT, where the median OS was 9.0 months (95% CI: 7.3-10.6). The observed effect of PET/CT was also statistically significant when comparing individual stages (IIIA, IIIB, IIIC). The multivariate Cox model confirmed the use of PET/CT as an independent prognostic factor. The most common reason for omission of PET/CT was the local or time unavailability of the examination. Conclusions: Omission of PET/CT can mean a significant decrement in survival for the patients in stage III NSCLC, likely due to poor staging and suboptimal treatment. Routine use of PET/CT is strictly recommended for the optimal management of stage III NSCLC patients even outside the high-income countries.
ER  -

KRAKOROVA, Gabriela, Petr DOMECKY, Jiri BLAZEK, Milos PESEK, Ondřej VENCLÍČEK, Libor HAVEL, Michal HRNCIARIK, Jana KREJCI, Andrea MULLEROVA, Miloslav MAREL, Jaroslav DUBA and Martin SVATON. Omission of staging PET/CT linked to reduced survival in stage III non-small cell lung cancer: insights from the LUCAS project real-world data. \textit{TRANSLATIONAL LUNG CANCER RESEARCH}. PEOPLES R CHINA: AME PUBL CO, 2024, vol.~13, No~7, p.~1-13. ISSN~2218-6751. Available from: https://dx.doi.org/10.21037/tlcr-24-108.

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