| 1. Jaklitsch MT, Jacobson FL, Austin JH, et al. The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg. 144(1):33-8, 2012 Jul. |
Review/Other-Dx |
N/A |
To create screening guidelines for groups at high risk of developing lung cancer and survivors of previous lung cancer. |
The American Association for Thoracic Surgery guidelines call for annual lung cancer screening with low-dose computed tomography screening for North Americans from age 55 to 79 years with a 30 pack-year history of smoking. Long-term lung cancer survivors should have annual low-dose computed tomography to detect second primary lung cancer until the age of 79 years. Annual low-dose computed tomography lung cancer screening should be offered starting at age 50 years with a 20 pack-year history if there is an additional cumulative risk of developing lung cancer of 5% or greater over the following 5 years. Lung cancer screening requires participation by a subspecialty-qualified team. The American Association for Thoracic Surgery will continue engagement with other specialty societies to refine future screening guidelines. |
4 |
| 2. Oliver AL. Lung Cancer: Epidemiology and Screening. Surg Clin North Am 2022;102:335-44. |
Review/Other-Dx |
N/A |
To discuss the Epidemiology and Screening of Lung Cancer |
No results stated in the abstract. |
4 |
| 3. Ettinger DS, Wood DE, Aisner DL, et al. Non-Small Cell Lung Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw.. 20(5):497-530, 2022 05. |
Review/Other-Dx |
N/A |
To discuss the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Small Cell Lung Cancer (NSCLC) provide recommended management for patients with NSCLC, including diagnosis, primary treatment, surveillance for relapse, and subsequent treatment. |
No results stated in the abstract. |
4 |
| 4. Huang K, Dahele M, Senan S, et al. Radiographic changes after lung stereotactic ablative radiotherapy (SABR)--can we distinguish recurrence from fibrosis? A systematic review of the literature. [Review]. Radiother Oncol. 102(3):335-42, 2012 Mar. |
Review/Other-Dx |
N/A |
To describe post-SABR findings on computed tomography (CT) and positron-emission tomography (PET), identify imaging characteristics that predict recurrence and propose a follow-up imaging algorithm. |
Acute changes post-SABR predominantly appear as consolidation or ground glass opacities. Late changes often demonstrate a modified conventional pattern of fibrosis, evolving beyond 2years after treatment. Several CT features, including an enlarging opacity, correlate with recurrence. Although PET SUVmax may rise immediately post-SABR, an SUVmax?5 carries a high predictive value of recurrence. |
4 |
| 5. Schneider BJ, Ismaila N, Aerts J, et al. Lung Cancer Surveillance After Definitive Curative-Intent Therapy: ASCO Guideline. J Clin Oncol. 38(7):753-766, 2020 03 01. |
Review/Other-Dx |
14 articles |
To provide evidence-based recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive curative-intent therapy in patients with stage I-III non-small-cell lung cancer (NSCLC) and SCLC. |
The literature search identified 14 relevant studies to inform the evidence base for this guideline. |
4 |
| 6. NCCN Clinical Practice Guidelines in Oncology. Non-Small Cell Lung Cancer. Version 3.2023. Available at: https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. |
Review/Other-Dx |
N/A |
To discuss the NCCN Clinical Practice Guidelines in Oncology. |
No results stated in the abstract |
4 |
| 7. Stirling RG, Chau C, Shareh A, Zalcberg J, Fischer BM. Effect of Follow-Up Surveillance After Curative-Intent Treatment of NSCLC on Detection of New and Recurrent Disease, Retreatment, and Survival: A Systematic Review and Meta-Analysis. J Thorac Oncol 2021;16:784-97. |
Observational-Dx |
N/A |
To performed a systematic review and meta-analysis of prospective studies on follow-up of NSCLC after curative-intent treatment to answer the following three questions: What is the effect of follow-up on detection of recurrence or SPLC? What is the effect of surveillance detection on curative-intent retreatment? What is the survival impact? |
Recurrence or SPLC was observed in 17.8% to 71% of patients. Scheduled imaging-detected recurrence in 60% to 100% of cases, yet neither computed tomography-based (OR = 2.31, 95% confidence interval [CI]: 0.27-19.49, p = 0.44) nor positron emission tomography-computed tomography-based follow-up (OR = 1.431, 95% CI: 0.92-2.22, p = 0.12) was statistically superior to standard follow-up strategies. Detection of disease recurrence/SPLC significantly increased the odds of curative-intent retreatment (OR = 4.31; 95% CI: 2.10-8.84, p < 0.0001). Curative-intent retreatment prolonged survival in reported studies. |
2 |
| 8. Gambazzi F, Frey LD, Bruehlmeier M, et al. Comparing Two Imaging Methods for Follow-Up of Lung Cancer Treatment: A Randomized Pilot Study. Ann Thorac Surg. 107(2):430-435, 2019 02. |
Experimental-Dx |
50 patients |
To compare the performance of integrated 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and contrast-enhanced computed tomography (CE-CT). |
The study enrolled 96 patients. In 14 of 50 patients (28%) in the PET-CT group and in 14 of 46 patients (30%) in the CE-CT group, a suspicious radiologic finding was confirmed as cancer recurrence after diagnostic workup. False-positive findings were detected in 11 patients (22%) of the PET-CT group and in 8 patients (17%) of the CE-CT group. The sensitivity, specificity, and positive predictive value for detecting cancer recurrence (95% confidence interval) were 0.88 (0.62 to 0.98), 0.62 (0.42 to 0.79), and 0.56 (0.35 to 0.76) for PET-CT and 0.93 (0.68 to 1.00), 0.72 (0.53 to 0.87), and 0.64 (0.41to 0.83) for CE-CT, respectively. |
1 |
| 9. Conforti F, Pala L, Pagan E, et al. Effectiveness of intensive clinical and radiological follow-up in patients with surgically resected NSCLC. Analysis of 2661 patients from the prospective MAGRIT trial. Eur J Cancer 2020;125:94-103. |
Observational-Dx |
2261 patients |
To analyze detection modality of disease recurrences and new primary lung cancer (i.e. detected by clinicoradiological scheduled exams versus by interim unscheduled exams), features associated with higher risk of locoregional and/or distant recurrence, and recurrence rates over time. |
In the 2261 patients studied, there was a significant association between the type of recurrence and the modality of detection: 88.4% (95% CI, 84%-91%) of the locoregional recurrences and 93.2% (95% CI, 84%-99%) of the new primary lung cancers were detected by scheduled exams, whereas this was only 68.7% (95% CI, 65%-73%) for distant metastases (p < 0.001). Survival of patients with locoregional recurrence or new primary lung cancer detected by scheduled exams was significantly better as compared with those detected by unscheduled exams (HR 0.56, 95% CI 0.36-0.87; p = 0.01). Survival was similarly poor in patients with distant recurrences, both with scheduled and unscheduled detection (3-year survival after recurrence 22.0% and 21.8%, respectively). Recurrence rate was the highest in the first 18 months after surgery-with a peak between month 6 and 12-decreasing thereafter. The hazard of a second primary lung cancer was constant over time. |
2 |
| 10. Spratt DE, Wu AJ, Adeseye V, et al. Recurrence Patterns and Second Primary Lung Cancers After Stereotactic Body Radiation Therapy for Early-Stage Non-Small-Cell Lung Cancer: Implications for Surveillance. Clin Lung Cancer 2016;17:177-83 e2. |
Observational-Dx |
366 patients |
To investigate the posttreatment recurrence patterns and development of second primary lung cancers (SPLCs). |
With a median follow-up of 23 months, the 2-year cumulative incidence of local, nodal, and distant treatment failures were 12.2%, 16.1%, and 15.5%, respectively. In patients with disease progression after SBRT (n = 108), 84% (n = 91) of cases occurred within the first 2 years. Five percent (n = 19) of patients experienced SPLCs. The median time to development of an SPLC was 16.5 months (range, 6.5-71.1 months), with 33% (n = 6) of these patients experiencing SPLCs after 2 years. None of the never smokers, but 4% of former tobacco smokers and 15% of current tobacco smokers, experienced an SPLC (P = .005). |
2 |
| 11. Westeel V, Barlesi F, Foucher P, et al. Results of the phase III IFCT-0302 trial assessing minimal versus CT-scan-based follow-up for completely resected non-small cell lung cancer (NSCLC). Annals of Oncology 2017;28:v452. |
Review/Other-Dx |
N/A |
To discuss the results of the phase III IFCT-0302 trial assessing minimal versus CT-scan-based follow-up for completely resected non-small cell lung cancer (NSCLC). |
No results stated in the abstract. |
4 |
| 12. Remon J, Soria JC, Peters S, clinicalguidelines@esmo.org EGCEa. Early and locally advanced non-small-cell lung cancer: an update of the ESMO Clinical Practice Guidelines focusing on diagnosis, staging, systemic and local therapy. Ann Oncol 2021;32:1637-42. |
Review/Other-Dx |
N/A |
To discuss the update the update of ESMO Clinical Practice, early and locally advanced non-small-cell lung cancer |
No results stated in the abstract. |
4 |
| 13. Colt HG, Murgu SD, Korst RJ, Slatore CG, Unger M, Quadrelli S. Follow-up and surveillance of the patient with lung cancer after curative-intent therapy: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 143(5 Suppl):e437S-e454S, 2013 May. |
Review/Other-Dx |
N/A |
To discuss the update of the evidence-based recommendations for follow-up and surveillance of patients after curative-intent therapy for lung cancer. Particular updates pertain to whether imaging studies, health-related quality-of-life (HRQOL) measures, tumor markers, and bronchoscopy improve outcomes after curative-intent therapy. |
A total of 3,412 citations from MEDLINE and 431 from CINAHL were identified. Only 303 were relevant. Seventy-six of the 303 articles were deemed eligible on the basis of predefined inclusion criteria after full-text review, but only 34 provided data pertaining directly to the subject of the questions formulated to guide this review. In patients undergoing curative-intent surgical resection of non-small cell lung cancer, chest CT imaging performed at designated time intervals after resection is suggested for detecting recurrence. It is recommended that treating physicians who are able to incorporate the patient's clinical findings into decision-making processes be included in follow-up and surveillance strategies. The use of validated HRQOL instruments at baseline and during follow-up is recommended. Biomarker testing during surveillance outside clinical trials is not suggested. Surveillance bronchoscopy is suggested for patients with early central airway squamous cell carcinoma treated by curative-intent photodynamic therapy and for patients with intraluminal bronchial carcinoid tumor who have undergone curative-intent bronchoscopic treatment with Nd:YAG laser or electrocautery. |
4 |
| 14. Postmus PE, Kerr KM, Oudkerk M, et al. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 28(suppl_4):iv1-iv21, 2017 07 01. |
Review/Other-Dx |
N/A |
To discuss the early and locally advanced non-small-cell lung cancer (NSCLC) |
No results stated in the abstract |
4 |
| 15. Lou F, Huang J, Sima CS, Dycoco J, Rusch V, Bach PB. Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance. Journal of Thoracic & Cardiovascular Surgery. 145(1):75-81; discussion 81-2, 2013 Jan. |
Review/Other-Dx |
1294 patients |
To sought to understand the patterns of recurrence and second primary lung cancer, and their mode of detection, after resection for early-stage non-small cell lung cancer in patients who were followed by routine surveillance computed tomography scan. |
A total of 1294 consecutive patients with early-stage non-small cell lung cancer underwent resection. The median length of follow-up was 35 months. Recurrence was diagnosed in 257 patients (20%), and second primary lung cancer was diagnosed in 91 patients (7%). The majority of new primary cancers (85 [93%]) were identified by scheduled routine computed tomography scan, as were a smaller majority of recurrences (157 [61%]). During the first 4 years after surgery, the risk of recurrence ranged from 6% to 10% per person-year but decreased thereafter to 2%. Conversely, the risk of second primary lung cancer ranged from 3% to 6% per person-year and did not diminish over time. Additional testing after false-positive surveillance computed tomography scan results was performed for 329 patients (25%), but only 4 of these patients (0.3%) experienced complications as a result of subsequent invasive diagnostic procedures. |
4 |
| 16. Srikantharajah D, Ghuman A, Nagendran M, Maruthappu M. Is computed tomography follow-up of patients after lobectomy for non-small cell lung cancer of benefit in terms of survival?. [Review]. Interactive Cardiovascular & Thoracic Surgery. 15(5):893-8, 2012 Nov. |
Observational-Dx |
N/A |
To address whether following up patients after lobectomy for non-small cell lung cancer (NSCLC) with computed tomography (CT) scanning is of benefit in terms of survival. |
One paper showed that detection by the use of low-dose CT or simultaneous chest CT plus positron emission tomography-CT led to a longer duration of survival compared with detection by clinical suspicion (2.1 ± 0.3 vs 3.6 ± 0.2 years, p = 0.002). However, two papers broadly showed that follow-up with CT does not improve survival outcomes regardless of the site of recurrence. One such study showed that there was no clinically significant difference in survival whether patients were followed up using a strict CT protocol compared with a symptom-based follow-up (median survival after recurrence: strict 7.9 months, symptom-based 6.6 months, p = 0.219). The remaining papers supported the use of CT as a screening tool for recurrence but did not comment directly on survival. Owing to the limited and contradictory evidence, there is a need for an randomized controlled trial to assess the survival outcomes of patients followed up with a CT screening protocol vs a symptom-based follow-up. |
2 |
| 17. Calman L, Beaver K, Hind D, Lorigan P, Roberts C, Lloyd-Jones M. Survival benefits from follow-up of patients with lung cancer: a systematic review and meta-analysis. J Thorac Oncol 2011;6:1993-2004. |
Meta-analysis |
9 studies |
To systematically review the published literature on follow-up strategies intended to improve survival and quality of life. |
Nine studies that examined the role of more intensive follow-up for patients with lung cancer were included (eight observational studies and one randomized controlled trial). The studies of curative resection included patients with non-small cell lung cancer Stages I to III disease, and studies of palliative treatment follow-up included limited and extensive stage patients with small cell lung cancer. A total of 1669 patients were included in the studies. Follow-up programs were heterogeneous and multifaceted. A nonsignificant trend for intensive follow-up to improve survival was identified, for the curative intent treatment subgroup (HR: 0.83; 95% confidence interval: 0.66-1.05). Asymptomatic recurrence was associated with increased survival, which was statistically significant HR: 0.61 (0.50-0.74) (p < 0.01); quality of life was only assessed in one study. |
Good |
| 18. Jazieh AR, Onal HC, Tan DSW, et al. Real-World Treatment Patterns and Clinical Outcomes in Patients With Stage III NSCLC: Results of KINDLE, a Multicountry Observational Study. J Thorac Oncol 2021;16:1733-44. |
Observational-Dx |
3151 patients |
To conduct a real-world, global study to characterize patients, treatment patterns, and their associated clinical outcomes for stage III NSCLC. |
A total of 3151 patients from more than 100 centers across 19 countries from Asia, Middle East, Africa, and Latin America were enrolled. Median age was 63.0 years (range: 21.0-92.0); 76.5% were males, 69.2% had a smoking history, 53.7% had adenocarcinoma, and 21.4% underwent curative resection. Of greater than 25 treatment regimens, concurrent chemoradiotherapy was the most common (29.4%). The overall median progression-free survival (95% confidence interval) and median overall survival (mOS) were 12.5 months (12.06-13.14) and 34.9 months (32.00-38.01), respectively. Significant associations (p < 0.05) were observed for median progression-free survival and mOS with respect to sex, region, smoking status, stage, histology, and Eastern Cooperative Oncology Group status. In univariate and multivariate analyses, younger age, stage IIIA, better Eastern Cooperative Oncology Group status, concurrent chemoradiotherapy, and surgery as initial therapy predicted better mOS. |
2 |
| 19. Schieda N, Siegelman ES. Update on CT and MRI of Adrenal Nodules. [Review]. AJR Am J Roentgenol. 208(6):1206-1217, 2017 Jun. |
Review/Other-Dx |
N/A |
To review the current role of CT and MRI for the characterization of adrenal nodules. |
Unenhanced CT and chemical-shift MRI have high specificity for lipid-rich adenomas. Dual-energy CT provides comparable to slightly lower sensitivity for the diagnosis of lipid-rich adenomas but may improve characterization of lipid-poor adenomas. Nonadenomas containing intracellular lipid pose an imaging challenge; however, nonadenomas that contain lipid may be potentially diagnosed using other imaging features. Multiphase adrenal washout CT can be used to differentiate lipid-poor adenomas from metastases but is limited for the diagnosis of hypervascular malignancies and pheochromocytoma. |
4 |
| 20. Colombi D, Di Lauro E, Silva M, et al. Non-small cell lung cancer after surgery and chemoradiotherapy: follow-up and response assessment. [Review]. Diagn Interv Radiol. 19(6):447-56, 2013 Nov-Dec. |
Observational-Dx |
N/A |
To outline the imaging assessment of tumor recurrence after surgery and the role of CT, magnetic resonance imaging, and PET-CT in the follow-up after chemotherapy, radiotherapy, and radiofrequency ablation. |
No results stated in the abstract |
4 |
| 21. Choi SH, Kim YT, Kim SK, et al. Positron emission tomography-computed tomography for postoperative surveillance in non-small cell lung cancer. Ann Thorac Surg. 92(5):1826-32; discussion 1832, 2011 Nov. |
Observational-Dx |
111 patients |
To prospectively implement PET-CT in our surveillance protocol for recurrence of NSCLC and investigated its effectiveness as compared with that of conventional methods. |
Recurrences were detected in 111 patients (31%). In 60 of these patients, recurrence was detected with conventional methods, and in the remaining 51 patients recurrences were detected with simultaneous PET-CT and chest CT. Among these latter patients, recurrence was evident in both the chest CT and PET-CT scans of 26 patients (51.0%), and in the PET-CT scans alone of 19 patients (37.3%). Five lung lesions (2 small, 1 subpleural, 1 cavitary, and 1 nodule of ground-glass opacity) and 1 pancreatic metastasis were detected with chest CT only. |
2 |
| 22. Sugimura H, Nichols FC, Yang P, et al. Survival after recurrent nonsmall-cell lung cancer after complete pulmonary resection. Ann Thorac Surg 2007;83:409-17; discussioin 17-8. |
Observational-Dx |
1,361 patients |
To discuss the follow up information of the survival after recurrent nonsmall-cell lung cancer after complete pulmonary resection. |
Follow-up was achieved in 1,073 patients, and recurrent cancer developed in 445. Complete information was available on 390 patients for analysis. There were 262 men and 128 women. Median age at time of recurrence was 69 years. Median time from surgical resection to recurrence was 11.5 months, and median postrecurrence survival was 8.1 months. Recurrence was intrathoracic in 171 patients, extrathoracic in 172, and a combination of both in 47. Treatments after recurrence included surgery in 43 patients, chemotherapy in 59, radiation in 73, and a combination in 96. All patients who received treatment survived longer than those who received no treatment. Preoperative chemotherapy and postoperative radiotherapy for the primary lung cancer, poor Eastern Cooperative Oncology Group Performance Status, decreased disease-free interval from initial resection to recurrence, symptoms at recurrence, and certain location of recurrence significantly decreased postrecurrence survival. |
2 |
| 23. Toba H, Sakiyama S, Otsuka H, et al. 18F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in postoperative follow-up of asymptomatic non-small-cell lung cancer patients. Interact Cardiovasc Thorac Surg. 15(5):859-64, 2012 Nov. |
Observational-Dx |
10 patients |
To evaluate the diagnostic capability of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in postoperative NSCLC patients without clinical and radiological evidence of recurrence, as a follow-up and surveillance programme. |
Eighteen (18%) asymptomatic patients had recurrent diseases and 22 recurrent sites were confirmed. Of 22 recurrent sites, recurrence was diagnosed by histological examination in 9 (41%) sites and by imaging examination in 13 (59%) sites. FDG-PET/CT correctly diagnosed recurrence in 17 of the 18 (94%) patients and 21 of the 22 (95%) recurrent sites. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 94.4, 97.6, 89.5, 98.8 and 97.0%, respectively. On the other hand, in 3 patients, other diseases were detected and treated appropriately. Post-recurrence therapies were performed in all patients with recurrence, but 4 (22%) patients died of the original diseases. The median post-recurrence survival was 25.2 months, and the 1- and 2-year post-recurrence survival rates were 83.3 and 69.6%, respectively. |
2 |
| 24. van Loon J, Grutters J, Wanders R, et al. Follow-up with 18FDG-PET-CT after radical radiotherapy with or without chemotherapy allows the detection of potentially curable progressive disease in non-small cell lung cancer patients: a prospective study. Eur J Cancer 2009;45:588-95. |
Observational-Dx |
24 patients |
To discuss the follow-up of patients treated with curative intent for non-small cell lung cancer (NSCLC) with X-ray or CT-scans is of unproven value |
Twenty four patients had PD 3 months post-treatment. 16/24 patients were symptomatic. No curative treatment could be offered to any of these patients. In 3/8 asymptomatic patients progression, potentially amenable for radical therapy was found, which were all detected with PET, not with CT only. |
2 |
| 25. Daly ME, Beckett LA, Chen AM. Does early posttreatment surveillance imaging affect subsequent management following stereotactic body radiation therapy for early-stage non-small cell lung cancer? Pract Radiat Oncol 2014;4:240-6. |
Observational-Dx |
62 patients |
To determine how routine use of early (<6 months) posttreatment imaging affects subsequent management. |
Sixty-two patients with 67 lung tumors underwent 92 early surveillance imaging studies (86 computed tomographic [CT] and 6 positron emission/CT) at a median of 2.1 months (range, 0.1-5.9 months). New lung nodules were identified in 8 patients (13%), leading to a diagnosis of metastatic disease treated with systemic therapy in 2 patients and biopsy proven solitary lung recurrence in 2 patients, both treated successfully with local therapy. Tumor growth meeting Response Evaluation Criteria in Solid Tumors (RECIST) criteria was identified in 1 patient, who was followed with subsequent radiographic regression. In aggregate, the treatment of 4 patients (6.5%, 95% CI 1.7%-15.2%) was altered by early imaging; 2 (3.2%, 95% CI 0.4%-10.8%) with a potentially curative intervention. No predictors for utility of early surveillance were identified. |
2 |
| 26. Ebright MI, Russo GA, Gupta A, Subramaniam RM, Fernando HC, Kachnic LA. Positron emission tomography combined with diagnostic chest computed tomography enhances detection of regional recurrence after stereotactic body radiation therapy for early stage non-small cell lung cancer. J Thorac Cardiovasc Surg. 145(3):709-15, 2013 Mar. |
Observational-Dx |
35 patients |
To determine whether positron emission tomography (PET) combined with diagnostic chest CT (PET/d-chest) can enhance detection of potentially salvageable recurrence after stereotactic body radiation therapy (SBRT). |
Median follow-up was 12.8 months. Twenty-four patients had stage IA, 7 stage IB, 3 stage IIA, and 1 stage IIB biopsy-proven NSCLC. Two-year overall survival was 62%. CT scans indicated no regional recurrences. PET/d-chest indicated 10 regional recurrences. The 1-year rate of regional recurrence-free survival as evaluated by CT and PET/d-chest was 100% and 69.4%, respectively (P = .0045). Four of 10 patients with a diagnosis of regional recurrence underwent salvage treatment with definitive chemoradiotherapy. |
2 |
| 27. Takenaka D, Ohno Y, Koyama H, et al. Integrated FDG-PET/CT vs. standard radiological examinations: comparison of capability for assessment of postoperative recurrence in non-small cell lung cancer patients. Eur J Radiol. 74(3):458-64, 2010 Jun. |
Observational-Dx |
92 patients |
To prospectively and directly compare diagnostic capabilities of whole-body integrated FDG-PET/CT and standard radiologic examination for assessment of recurrence in postoperative non-small cell lung cancer (NSCLC) patients. |
All inter-observer agreements were almost perfect (integrated PET/CT: kappa=0.89; standard radiological examination: kappa=0.81). There were no statistically significant differences in area under the curve, sensitivity, specificity and accuracy between integrated FDG-PET/CT and standard radiologic examinations (p>0.05). |
2 |
| 28. Cho S, Lee EB. A follow-up of integrated positron emission tomography/computed tomography after curative resection of non-small-cell lung cancer in asymptomatic patients. J Thorac Cardiovasc Surg 2010;139:1447-51. |
Observational-Dx |
86 patients |
To evaluate the results of this follow-up integrated PET/CT in patients treated for non-small-cell lung cancer without symptoms or abnormal findings. |
The time from operation to the follow-up integrated PET/CT check was 13.4 +/- 4.4 months. Integrated PET/CT showed negative findings in 41 (47.7%) patients, equivocal findings in 16 (18.6%) patients, and positive findings in 29 (33.7%) patients. Twenty-seven (31.4%) patients had recurrent disease and 2 patients had extrathoracic double primary cancer. Six patients had extrathoracic recurrence without intrathoracic recurrence. |
2 |
| 29. Toba H, Kawakita N, Takashima M, et al. Diagnosis of recurrence and follow-up using FDG-PET/CT for postoperative non-small-cell lung cancer patients. Gen Thorac Cardiovasc Surg. 69(2):311-317, 2021 Feb. |
Observational-Dx |
187 patients |
To examined the diagnostic capability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for detecting recurrence in postoperative NSCLC patients, and we evaluated the results of postoperative surveillance using FDG-PET/CT in asymptomatic patients. |
FDG-PET/CT correctly diagnosed recurrence in 46 of 47 (97.9%) patients and 68 of 69 (98.6%) recurrent sites. The following were obtained: 97.9% sensitivity, 97.1% specificity, 92.0% positive predictive value, 99.3% negative predictive value, and 97.3% accuracy. In six patients, other diseases were detected and treated appropriately. In asymptomatic patients, the detection rate of recurrence in the stage III group was significantly higher than the detection rates in the stage I and II groups, and FDG-PET/CT performed = 3 years post-resection detected significantly more FDG-positive lesions compared to that performed after 4 years. |
2 |
| 30. Wang Y, Lanuti M, Bernheim A, Shepard JO, Sharma A. Fluorodeoxyglucose positron emission tomography for detection of tumor recurrence following radiofrequency ablation in retrospective cohort of stage I lung cancer. Int J Hyperthermia. 35(1):1-8, 2018. |
Observational-Dx |
N/A |
To define patterns for tumor recurrence on PET following RFA, compare time to imaging recurrence by PET versus CT, evaluate whether pre-treatment tumor uptake predicts recurrence and propose an optimal post-RFA surveillance strategy. |
Thirteen recurrences after 72 RFA treatments were confirmed by diagnostic CT. All recurrences were associated with focally intense and increasing FDG uptake beyond 6 months (sensitivity 100%; specificity 98.5%). Mean TTR_PET was 14 months compared to mean TTR_CT of 17 months (not statistically significant). Normalized SUVmax and total lesions glycolysis of lung cancers that recurred after RFA was 4.0 and 6.0, respectively compared to 2.8 and 5.0, respectively for cancers that did not recur (p = .068). |
2 |
| 31. Izaaryene J, Vidal V, Bartoli JM, Loundou A, Gaubert JY. Role of dual-energy computed tomography in detecting early recurrences of lung tumours treated with radiofrequency ablation. Int J Hyperthermia. 33(6):653-658, 2017 09. |
Observational-Dx |
70 patients |
To investigate the utility of dual-energy computed tomography (DECT) in order to assess therapeutic responses to RFA for lung neoplasia. |
The study included 70 consecutive patients, and 191 DECT measures were performed. We collected the enhancement values of all scars without establishing a prior threshold of positivity. The optimal threshold value areas appeared to be located between 20 and 35 Hounsfield unit (HU) with sensitivity between 70% and 82%; specificity between 72% and 90%; a negative predictive value (NPV) between 96% and 97% and a diagnostic accuracy index between 73% and 87%. At the one month follow-up, 53 nodules were analysed with DECT and four nodules had recurred, all of which were detected by DECT. The sensitivity, which was calculated at 100%, was excellent; the NPV was at 100% (CI: 91.62, 100) and the specificity was at 85.71% (CI: 73.33, 92.9). The diagnostic accuracy index was 86.79% (CI: 75.16, 93.45) and the average DECT acquisitions dosimetry was 106 mGy.cm (33mGy.cm 245mGy.cm). |
2 |
| 32. Nomori H, Mori T, Ikeda K, et al. Diffusion-weighted magnetic resonance imaging can be used in place of positron emission tomography for N staging of non-small cell lung cancer with fewer false-positive results. J Thorac Cardiovasc Surg 2008;135:816-22. |
Observational-Dx |
88 patients |
To examine the usefulness of diffusion-weighted magnetic resonance imaging for N staging of non-small cell lung cancer compared with positron emission tomography-computed tomography. |
The accuracy of N staging in the 88 patients was 0.89 with diffusion-weighted magnetic resonance imaging, which was significantly higher than the value of 0.78 obtained with positron emission tomography-computed tomography (P = .012), because of less overstaging in the former. Among the 734 lymph node stations examined pathologically, 36 had metastases, and the other 698 did not. Although there was no significant difference in the diagnosis of the 36 metastatic lymph node stations between the 2 methods, diffusion-weighted magnetic resonance imaging was more accurate for diagnosing the 698 nonmetastatic stations than positron emission tomography-computed tomography because of fewer false-positive results (P = .002). The detectable size of metastatic foci within lymph nodes was 4 mm in both positron emission tomography-computed tomography and diffusion-weighted magnetic resonance imaging. |
2 |
| 33. Wielputz M, Kauczor HU. MRI of the lung: state of the art. [Review]. Diagn Interv Radiol. 18(4):344-53, 2012 Jul-Aug. |
Review/Other-Dx |
N/A |
To review the technical aspects and protocol suggestions for chest MRI and discuss the role of MRI in the evaluation of nodules and masses, airway disease, respiratory mechanics, ventilation, perfusion and hemodynamics, and pulmonary vasculature. |
No results stated in the abstract. |
4 |
| 34. Turkbey B, Aras O, Karabulut N, et al. Diffusion-weighted MRI for detecting and monitoring cancer: a review of current applications in body imaging. Diagn Interv Radiol 2012;18:46-59. |
Review/Other-Dx |
N/A |
To review the basic concepts, imaging strategies, and body applications of diffusion-weighted MRI in detecting and monitoring cancer. |
No results was stated in the abstract |
4 |
| 35. Sun DS, Hu LK, Cai Y, et al. A systematic review of risk factors for brain metastases and value of prophylactic cranial irradiation in non-small cell lung cancer. Asian Pac J Cancer Prev 2014;15:1233-9. |
Meta-analysis |
8 articles |
To discuss the meta-analysis on risk factors for brain metastases (BM) and the value of prophylactic cranial irradiation (PCI) in patients with non-small cell lung cancer(NSCLC). |
Six randomized controlled trials with a focus on the value of PCI and 13 eligible studies with a focus on risk factors for BM were included. PCI significantly reduced the incidence of BM in patients with NSCLC (p=0.000, pooled OR=0.34, 95% confidence interval = 0.37-0.59). Compared with non-squamous cell carcinoma, squamous cell carcinoma was associated with a low incidence of BM in patients with NSCLC (p=0.000, pooled OR=0.47, 95% confidence interval =0.34- 0.65). The funnel plot and Egger's test suggested that there was no publication bias in the current meta-analysis. |
Good |
| 36. Vansteenkiste J, De Ruysscher D, Eberhardt WE, et al. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24 Suppl 6:vi89-98. |
Review/Other-Dx |
N/A |
To discuss the ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. |
No results state din the abstract. |
4 |
| 37. Hanna WC, Paul NS, Darling GE, et al. Minimal-dose computed tomography is superior to chest x-ray for the follow-up and treatment of patients with resected lung cancer. J Thorac Cardiovasc Surg. 147(1):30-3, 2014 Jan. |
Observational-Dx |
271 patients |
To hypothesize that in patients with completely resected lung cancer, surveillance with MnDCT, when compared with CXR, leads to earlier detection and a higher rate of treatment of new or recurrent lung cancer. |
Between 2007 and 2012, 271 patients were included and 1137 pairs of CXR and MnDCT were analyzed. MnDCT was more sensitive (94% vs 21%; P < .0001) and had a higher negative predictive value (99% vs 96%; P = .007) than CXR for the diagnosis of new or recurrent lung cancer. The prevalence of new or recurrent lung cancer was 23.2% (63 of 271), of whom 78% (49 of 63) had asymptomatic disease. The majority of asymptomatic patients (75%; 37 of 49) were treated with curative intent and had a median survival of 69 months. The remainder of patients received palliative treatment (24%; 12 of 49) and had a median survival of 25 months (P < .0001). |
2 |
| 38. Butof R, Gumina C, Valentini C, et al. Sites of recurrent disease and prognostic factors in SCLC patients treated with radiochemotherapy. Clin Transl Radiat Oncol 2017;7:36-42. |
Observational-Dx |
13 patients |
To assess the sites of recurrent disease in small cell lung cancer (SCLC) and to evaluate the feasibility of selective node irradiation (SNI) versus elective nodal irradiation (ENI). |
13 patients (30%) relapsed locally or regionally: six within the initial primary tumor volume, five within the initially affected lymph nodes, one metachronously within primary tumor and initially affected lymph nodes, and one both inside and outside of the initial nodal disease. All sites of loco-regional recurrence had received 92-106% of the prescribed dose. |
2 |
| 39. Sheikhbahaei S, Mena E, Yanamadala A, et al. The Value of FDG PET/CT in Treatment Response Assessment, Follow-Up, and Surveillance of Lung Cancer. [Review]. AJR Am J Roentgenol. 208(2):420-433, 2017 Feb. |
Review/Other-Dx |
N/A |
To summarize the evidence regarding the role of FDG PET/CT in treatment response assessment and surveillance of lung cancer and to provide suggested best practices. |
FDG PET/CT is a valuable imaging tool for assessing treatment response for patients with lung cancer, though evidence for its comparative effectiveness with chest CT is still evolving. FDG PET/CT is most useful when there is clinical suspicion or other evidence for disease recurrence or metastases. The sequencing, cost analysis, and comparative effectiveness of FDG PET/CT and conventional imaging modalities in the follow-up setting need to be investigated. |
4 |
| 40. Idhe DC, Pass HI, Glatstein E. Small cell lung cancer. In: DeVita VT, Hellman, S, Rosenberg, SA, ed. Principles and practice of oncology. 5th ed. Philadelphia, Pa: Lippincott-Raven; 1997:911–49. |
Review/Other-Dx |
N/A |
To review the current evidence for the use of second-line cytotoxic therapy and also the emerging role of novel agents and targeted therapies in this setting. |
No results stated in the abstract. |
4 |
| 41. Qu X, Huang X, Yan W, Wu L, Dai K. A meta-analysis of 18FDG-PET-CT, 18FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with lung cancer. [Review]. Eur J Radiol. 81(5):1007-15, 2012 May. |
Meta-analysis |
17 studies |
To evaluate and compare the capability for bone metastasis assessment of [(18)F] fluoro-2-d-glucose positron emission tomography with computed tomography ((18)FDG-PET-CT), [(18)F] fluoro-2-d-glucose positron emission tomography ((18)FDG-PET), magnetic resonance imaging (MRI) and bone scintigraphy (BS) in lung cancer patients, a meta-analysis is preformed. |
A total of 17 articles (9 (18)FDG-PET-CT studies, 9 (18)FDG-PET studies, 6 MRI studies and 16 BS studies) that included 2940 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for the detection of bone metastasis in lung cancer using (18)FDG-PET-CT, (18)FDG-PET, MRI and BS were 0.92 (95% CI, 0.88-0.95), 0.87 (95% CI, 0.81-0.92), 0.77 (95% CI, 0.65-0.87) and 0.86 (95% CI, 0.82-0.89), respectively. The pooled specificity for the detection of bone metastasis from lung cancer using (18)FDG-PET-CT, (18)FDG-PET, MRI and BS were 0.98 (95% CI, 0.97-0.98), 0.94 (95% CI, 0.92-0.96), 0.92 (95% CI, 0.88-0.95), 0.88 (95% CI, 0.86-0.89), respectively. The pooled DORs estimates for (18)FDG-PET-CT 449.17 were significantly higher than for (18)FDG-PET (118.25, P<0.001), MRI (38.27, P<0.001) and BS (63.37, P<0.001). The pooled sensitivity of BS was not correlated with the prevalence of bone metastasis. |
Good |
| 42. Ganti AKP, Loo BW, Bassetti M, et al. Small Cell Lung Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw.. 19(12):1441-1464, 2021 12. |
Review/Other-Dx |
N/A |
To provide recommended management for patients with SCLC, including diagnosis, primary treatment, surveillance for relapse, and subsequent treatment. This selection for the journal focuses on metastatic (known as extensive-stage) SCLC, which is more common than limited-stage SCLC. |
No results stated in the abstract. |
4 |
| 43. Sheikhbahaei S, Verde F, Hales RK, Rowe SP, Solnes LB. Imaging in Therapy Response Assessment and Surveillance of Lung Cancer: Evidenced-based Review With Focus on the Utility of 18F-FDG PET/CT. [Review]. CLIN LUNG CANCER. 21(6):485-497, 2020 11. |
Review/Other-Dx |
N/A |
To review different qualitative and quantitative response assessment criteria in lung cancer, common pitfalls and atypical patterns of response to immunotherapy, and imaging features of common immune-related adverse events. In addition, the currently recommended imaging workup in surveillance of asymptomatic patients with non-small-cell and small-cell lung cancer and future developments will be discussed. |
No results stated in the abstract. |
4 |
| 44. Jett JR, Schild SE, Kesler KA, Kalemkerian GP. Treatment of small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 143(5 Suppl):e400S-e419S, 2013 May. |
Review/Other-Dx |
9 studies |
To revise the evidence-based guidelines on staging and best available treatment options. |
The staging classification should include both the old Veterans Administration staging classification of limited stage (LS) and extensive stage (ES), as well as the new seventh edition American Joint Committee on Cancer/International Union Against Cancer staging by TNM. The use of PET scanning is likely to improve the accuracy of staging. Surgery is indicated for carefully selected stage I SCLC. LS disease should be treated with concurrent chemoradiotherapy in patients with good performance status. Thoracic radiotherapy should be administered early in the course of treatment, preferably beginning with cycle 1 or 2 of chemotherapy. Chemotherapy should consist of four cycles of a platinum agent and etoposide. ES disease should be treated primarily with chemotherapy consisting of a platinum agent plus etoposide or irinotecan. Prophylactic cranial irradiation prolongs survival in those individuals with both LS and ES disease who achieve a complete or partial response to initial therapy. To date, no molecularly targeted therapy agent has demonstrated proven efficacy against SCLC. |
4 |
| 45. Kalemkerian GP, Loo BW, Akerley W, et al. NCCN Guidelines Insights: Small Cell Lung Cancer, Version 2.2018. J. Natl. Compr. Cancer Netw.. 16(10):1171-1182, 2018 10. |
Review/Other-Dx |
N/A |
To focus on recent updates to the NCCN Guidelines for SCLC regarding immunotherapy, systemic therapy, and radiation therapy (2018 update, new sections were added on "Signs and Symptoms of SCLC" and "Principles of Pathologic Review). |
No results stated in the abstract. |
4 |
| 46. Carter BW, Glisson BS, Truong MT, Erasmus JJ. Small cell lung carcinoma: staging, imaging, and treatment considerations. Radiographics. 2014;34(6):1707-1721. |
Review/Other-Dx |
N/A |
To review the staging, imaging, and treatment considerations of small cell lung carcinoma. |
No results stated in abstract. |
4 |
| 47. Arslan N, Tuncel M, Kuzhan O, et al. Evaluation of outcome prediction and disease extension by quantitative 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography in patients with small cell lung cancer. Ann Nucl Med. 2011;25(6):406-413. |
Observational-Dx |
25 patients |
To determine whether 2-deoxy-2-[18F] fluoro-D: -glucose with positron emission tomography (FDG-PET) imaging and quantitative PET parameters can predict outcome and differentiate patients with limited disease (LD) from extensive disease (ED) in patients with small cell lung cancer (SCLC). |
By conventional methods 14 of 25 (56%) patients were reported to have LD and 11 of 25 (44%) had ED. FDG-PET scan upstaged 9 out of 25 (36%) and downstaged 2 out of 25 (%8) patients. Among the quantitative PET parameters, total lesion glycolysis (TLG) were the only PET parameters that differentiated between Group A and Group B patients. FDG-PET staging (p = 0.019) could predict significant survival difference between stages on contrary to conventional staging (p = 0.055). Moreover, TLG [SUV(max) > %50] was the only quantitative PET parameter that could predict survival (p = 0.027). |
3 |
| 48. Azad A, Chionh F, Scott AM, et al. High impact of 18F-FDG-PET on management and prognostic stratification of newly diagnosed small cell lung cancer. Mol Imaging Biol. 2010;12(4):443-451. |
Observational-Dx |
46 patients |
To the impact on stage classification and management, in this study, we sought to evaluate the association between stage classification withPositron-Emission Tomography (PET) and prognosis in newly diagnosed small cell lung cancer (SCLC). |
PET altered stage classification in 12 of 46 (26%) patients. PET altered treatment modality in nine patients, and the target mediastinal radiation field in another three patients. Therefore, PET altered management in 12 of 46 (26%) patients. Patients with limited disease (LD) on pre-PET staging had significantly longer overall survival (OS) than those upstaged to extensive disease (Extensive disease (ED); median 18.6 months versus 5.7 months; log-rank p < 0.0001). In patients with ED on pre-PET staging, those downstaged to LD by PET had significantly longer OS than those with ED on PET (median 10.9 months versus 5.9 months; log-rank p = 0.037). |
3 |
| 49. Kalemkerian GP, Gadgeel SM. Modern staging of small cell lung cancer. J Natl Compr Canc Netw. 2013;11(1):99-104. |
Review/Other-Dx |
N/A |
To review the modern staging of small cell lung cancer. |
No results stated in abstract. |
4 |
| 50. Kalemkerian GP, Akerley W, Bogner P, et al. Small cell lung cancer. J. Natl. Compr. Cancer Netw.. 11(1):78-98, 2013 Jan 01. |
Review/Other-Dx |
N/A |
To focus on extensive-stage small cell lung cancer (SCLC) because it occurs more frequently than limited-stage disease. |
No results stated in the abstract. |
4 |
| 51. Marcus C, Paidpally V, Antoniou A, Zaheer A, Wahl RL, Subramaniam RM. 18F-FDG PET/CT and lung cancer: value of fourth and subsequent posttherapy follow-up scans for patient management. J Nucl Med. 56(2):204-8, 2015 Feb. |
Observational-Dx |
85 patients |
To evaluate the added value of 4 or more follow-up PET/CT scans to clinical assessment and impact on patient management. |
Of the 285 fourth and subsequent follow-up PET/CT scans, 149 (52.28%) were interpreted as positive and 136 (47.7%) as negative for recurrence or metastasis. A total of 47 patients (55.3%) died during the study period. PET/CT identified recurrence or metastasis in 44.3% of scans performed without prior clinical suspicion and ruled out recurrence or metastasis in 24.2% of scans performed with prior clinical suspicion. The PET/CT scan resulted in a treatment change in 28.1% (80/285) of the patients. New treatment was initiated for 20.4% (58/285) of the scans, treatment was changed in 5.6% (16/285), and ongoing treatment was stopped in 2.1% (6/285). |
2 |
| 52. Hurwitz JL, McCoy F, Scullin P, Fennell DA. New advances in the second-line treatment of small cell lung cancer. [Review] [80 refs]. Oncologist. 14(10):986-94, 2009 Oct. |
Review/Other-Dx |
N/A |
To review the current evidence for the use of second-line cytotoxic therapy and also the emerging role of novel agents and targeted therapies in this setting. |
No results stated in the abstract. |
4 |
| 53. Colice GL, Rubins J, Unger M, American College of Chest P. . Chest 2003;123:272S-83S.Follow-up and surveillance of the lung cancer patient following curative-intent therapy |
Review/Other-Dx |
840 patients |
To discuss the follow-up and surveillance of the lung cancer patient following curative-intent therapy. |
No results stated in the abstract. |
4 |
| 54. Senthi S, Lagerwaard FJ, Haasbeek CJ, Slotman BJ, Senan S. Patterns of disease recurrence after stereotactic ablative radiotherapy for early stage non-small-cell lung cancer: a retrospective analysis. Lancet Oncol. 13(8):802-9, 2012 Aug. |
Review/Other-Tx |
676 patients |
To assess patterns of late disease recurrence outcomes after stereotactic ablative RT in a cohort of patients with NSCLC. |
The median follow-up was 32.9 months (IQR 14.9-50.9 months). 124 (18%) of 676 patients had disease recurrence. Actuarial 2-year rates of local, regional, and distant recurrence were 4.9% (95% CI 2.7-7.1), 7.8% (5.3-10.3), and 14.7% (11.4-18.0), respectively. Corresponding 5-year rates were 10.5% (95% CI 6.4-14.6), 12.7% (8.4-17.0), and 19.9% (14.9-24.6), respectively. Of the 124 recurrences, 82 (66%) were distant recurrences and 57 (46%) were isolated distant recurrences. Isolated locoregional recurrences occurred in the remaining 42 patients with disease recurrence (34%), 35 (83%) of whom did not develop subsequent distant recurrence. The median times to local, regional, and distant recurrence were 14.9 months (95% CI 11.4-18.4), 13.1 months (7.9-18.3), and 9.6 months (6.8-12.4), respectively. New pulmonary lesions characterized as second primary tumors in the lung developed in 42 (6%) of 676 patients at a median of 18.0 months (95% CI 12.5-23.5) after stereotactic ablative RT. |
4 |
| 55. Song IH, Yeom SW, Heo S, et al. Prognostic factors for post-recurrence survival in patients with completely resected Stage I non-small-cell lung cancer. Eur J Cardiothorac Surg. 45(2):262-7, 2014 Feb. |
Observational-Dx |
72 patients |
To examine the clinical outcomes after postoperative recurrence in patients with completely resected Stage I NSCLC. |
Seventy-two patients experienced recurrence during a median follow-up period of 37.5 months. Thirteen patients (18%) presented symptoms at the initial recurrence. Tumour markers, computed tomography (CT) and positron emission tomography/CT were chosen as the initial diagnostic tools and detected recurrences in 1 (1%), 51 (71%) and 7 (10%) patients, respectively. The mean recurrence-free interval (RFI) was 15.4 months (=12 months in 34, >12 months in 38 patients). The patterns of recurrence were presented as loco-regional recurrence in 36 (50%) and distant metastasis in 36 patients (50%). Types of the initial treatment included operations in 28 (39%), chemotherapy and/or radiotherapy in 38 (53%) and radiofrequency ablation in 2 patients (3%). Four patients (6%) rejected treatment. Forty-three patients (62%) presented a good response to the initial treatment. Thirty-seven patients (51%) died, and the cause of death in all of these patients was cancer-related. The median survival duration after recurrence was 43.6 (1-136) months. Univariate analysis identified no recurrence of symptoms, a good response to treatment and a longer RFI as good prognostic factors, while a good response to treatment and a longer RFI were independent prognostic factors in multivariate analysis. |
2 |
| 56. Lou F, Sima CS, Rusch VW, Jones DR, Huang J. Differences in patterns of recurrence in early-stage versus locally advanced non-small cell lung cancer. Ann Thorac Surg. 98(5):1755-60; discussion 1760-1, 2014 Nov. |
Observational-Dx |
1,640 patients |
To compare patterns of recurrence and modes of detection in surgically treated patients with pathologic early-stage and locally advanced NSCLC. |
In total, 1,640 patients were identified: 181 of 346 patients with stage IIIA NSCLC (52%) and 257 of 1,294 patients with stage I-II NSCLC (20%) experienced recurrences. Surveillance CT detected asymptomatic recurrences in 157 stage I-II patients (61%) and 89 stage IIIA patients (49%) (p=0.045). Symptoms led to detection of recurrences more often in stage IIIA patients (73, 40%) than in stage I-II patients (81, 32%). Distant recurrences were more common in stage IIIA patients than in stage I-II patients (153, 85%, vs 190, 74%; p=0.01). In stage IIIA patients, the risk of recurrence was highest during the first 2 years after operation, but it remained substantial into year 4. |
2 |
| 57. Subotic D, Mandaric D, Radosavljevic G, Stojsic J, Gajic M, Ercegovac M. Relapse in resected lung cancer revisited: does intensified follow up really matter? A prospective study. World J Surg Oncol 2009;7:87. |
Observational-Dx |
88 patients |
To discuss a prospective, controlled study on 88 patients operated for non-small cell lung cancer (NSCLC) in a 15 months period. |
postoperative lung cancer relapse occurred in 50(56.8%) patients. Locoregional, distant and both types of relapse occurred in 26%, 70% and 4% patients respectively. Postoperative cancer relapse occurred in 27/35(77.1%) pts. in the stage IIIA and in 21/40(52.55) pts in the stage IIB. In none of four pts. in the stage IIA cancer relapse occurred, unlike 22.22% pts. with relapse in the stage IB. The mean disease free interval in the analysed group was 34.38 +/- 3.26 months.The mean local relapse free and distant relapse free intervals were 55 +/- 3.32 and 41.62 +/- 3.47 months respectively Among 30 pts. with the relapse onset inside the first 12 month after the lung resection, in 20(66.6%) pts. either T3 tumours or N2 lesions existed. In patients with N0, N1 and N2 lesions, cancer relapse occurred in 30%, 55.6% and 70.8% patients respectively. Radiographic aspect T stage, N stage and extent of resection were found as significant in terms of survival. Related to the relapse occurrence, although radiographic aspect and extent of resection followed the same trend as in the survival analysis, only T stage and N stage were found as significant in the same sense as for survival. On multivariate, only T and N stage were found as significant in terms of survival.Specific oncological treatment of relapse was possible in 27/50(54%) patients. |
2 |
| 58. Onishi Y, Ohno Y, Koyama H, et al. Non-small cell carcinoma: comparison of postoperative intra- and extrathoracic recurrence assessment capability of qualitatively and/or quantitatively assessed FDG-PET/CT and standard radiological examinations. Eur J Radiol. 79(3):473-9, 2011 Sep. |
Observational-Dx |
121 patients |
To compare the capability of integrated FDG-PET/CT for assessment of postoperative intra- and extrathoracic recurrence in non-small cell lung cancer (NSCLC) patients with that of standard radiological examinations. |
Areas under the curve of qualitatively assessed PET/CT and standard radiological examinations showed no significant differences (p>0.05). At an optimal cut-off value of 2.5, specificity and accuracy of quantitatively and qualitatively assessed PET/CT were significantly higher than those of qualitatively assessed PET/CT and standard radiological examinations (p<0.05). |
2 |
| 59. Kosteva J, Langer C. The changing landscape of the medical management of skeletal metastases in nonsmall cell lung cancer. Curr Opin Oncol 2008;20:155-61. |
Review/Other-Dx |
N/A |
To discuss the changing landscape of the medical management of skeletal metastases in nonsmall cell lung cancer. |
In recent years, bisphosphonates such as zoledronic acid have shown efficacy in preventing and delaying skeletal-related events in patients with a variety of solid tumors, including nonsmall cell lung cancer. Biochemical markers of bone turnover such as bone-specific alkaline phosphatase and N-terminal telopeptide of collagen type I have shown some utility in predicting which patients are at greatest risk of developing skeletal-related events. These biochemical markers may play a role in directing treatment of skeletal metastases with either bisphosphonates or newer targeted therapies such as denosumab. |
4 |
| 60. Birim O, Kappetein AP, Stijnen T, Bogers AJ. Meta-analysis of positron emission tomographic and computed tomographic imaging in detecting mediastinal lymph node metastases in nonsmall cell lung cancer. Ann Thorac Surg. 2005;79(1):375-382. |
Meta-analysis |
17 studies |
To perform a meta-analysis to estimate the diagnostic accuracy of fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) versus computed tomographic (CT) imaging on detecting mediastinal lymph node metastases in patients with nonsmall cell lung cancer (NSCLC). |
No results stated in abstract. |
Good |
| 61. van Tinteren H, Hoekstra OS, Smit EF, et al. Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial. Lancet. 2002;359(9315):1388-1393. |
Experimental-Dx |
188 patients from 9 hospitals: 96 conventional workup; 92 conventional workup plus PET |
A randomized controlled trial to test whether FDG-PET reduces the number of futile thoracotomies in patients with suspected NSCLC, scheduled for surgery after conventional workup. |
18 patients in the conventional workup group and 32 in the conventional workup+PET group did not have thoracotomy. In the conventional workup group, 39 (41%) patients had a futile thoracotomy, compared with 19 (21%) in the conventional workup+PET group (relative reduction 51%, 95% CI 32-80%; P=0.003). Addition of PET to conventional workup prevented unnecessary surgery in one out of five patients with suspected NSCLC. |
1 |
| 62. Al-Ibraheem A, Hirmas N, Fanti S, et al. Impact of 18F-FDG PET/CT, CT and EBUS/TBNA on preoperative mediastinal nodal staging of NSCLC. BMC med. imaging. 21(1):49, 2021 03 17. |
Observational-Dx |
158 |
To investigate the diagnostic accuracy of 18F-FDG PET/CT, CT scan, and endobronchial ultrasound/transbronchial needle aspirate (EBUS/TBNA) in preoperative mediastinal lymph nodes (MLNs) staging of NSCLC. |
18F-FDG PET/CT, in comparison to CT, had a better sensitivity (90.5% vs. 75%, p = 0.04) overall and in patients with histopathological confirmation (83.3% vs. 54.6%), and better specificity (60.5% vs. 43.6%, p = 0.01) overall and in patients with histopathological confirmation in MLN staging (60.6% vs. 38.2%). Negative predictive value of mediastinoscopy, EBUS/TBNA, and 18F-FDG PET/CT were (87.1%), (90.91%), and (83.33%) respectively. The overall accuracy was highest for mediastinoscopy (88.6%) and EBUS/TBNA (88.2%), followed by 18F-FDG PET/CT (70.2%). Dividing patients into N1 disease vs. those with N2/N3 disease yielded similar findings. Comparison between 18F-FDG PET/CT and EBUS/TBNA in patients with histopathological confirmation shows 28 correlated true positive and true negative findings with final N-staging. In four patients, 18F-FDG PET/CT detected metastatic MLNs that would have otherwise remained undiscovered by EBUS/TBNA alone. Lymph nodes with a maximal standardized uptake value (SUVmax) more than 3 were significantly more likely to be true-positive. |
1 |
| 63. Hung JJ, Yeh YC, Jeng WJ, et al. Prognostic Factors of Survival after Recurrence in Patients with Resected Lung Adenocarcinoma. J Thorac Oncol. 10(9):1328-1336, 2015 Sep. |
Observational-Dx |
81 patients |
To investigate the prognostic factors of postrecurrence survival (PRS) in patients of resected lung adenocarcinoma. |
The pattern of recurrence included local only in 25 (15.4%), distant only in 56 (34.6%), and both local and distant in 81 (50.0%) of patients. The 2-year and 5-year PRS were 65.2% and 29.8%, respectively. The most common organ sites of metastasis were the contralateral lung (39.1%), followed by the brain (33.5%) and the bone (31.3%). Multivariate analysis revealed that micropapillary/solid predominant pattern group (versus acinar/papillary; hazard ratio = 2.615; 95% confidence interval: 1.395-4.901; p = 0.003) and no treatment for recurrence (p < 0.001) were significant prognostic factors of worse PRS. For patients receiving treatment for recurrence, micropapillary/solid predominant pattern group (versus acinar/papillary; hazard ratio = 2.570; 95% confidence interval: 1.357-4.865; p = 0.004) was a significant predictive factor of worse PRS. Treatment for recurrence with surgery (p = 0.067) tended to be a significant predictive factor of better PRS. |
2 |
| 64. Silvestri GA, Gonzalez AV, Jantz MA, et al. Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 143(5 Suppl):e211S-e250S, 2013 May. |
Review/Other-Dx |
N/A |
To provide guidelines for Diagnosis and management of lung cancer. |
The sensitivity and specificity of computed tomography (CT) scanning for identifying mediastinal lymph node metastasis were approximately 55% and 81%, respectively, confirming that CT scanning has limited ability either to rule in or exclude mediastinal metastasis. For Positron-Emission Tomography (PET) scanning, estimates of sensitivity and specificity for identifying mediastinal metastasis were approximately 77% and 86%, respectively. These findings demonstrate that PET scanning is more accurate than CT scanning, but tissue biopsy is still required to confirm PET scan findings. The needle techniques endobronchial ultrasound-needle aspiration, endoscopic ultrasound-needle aspiration, and combined endobronchial ultrasound/endoscopic ultrasound-needle aspiration have sensitivities of approximately 89%, 89%, and 91%, respectively. In direct comparison with surgical staging, needle techniques have emerged as the best first diagnostic tools to obtain tissue. Based on randomized controlled trials, PET or PET-CT scanning is recommended for staging and to detect unsuspected metastatic disease and avoid noncurative resections. |
4 |
| 65. Edelman MJ, Meyers FJ, Siegel D. The utility of follow-up testing after curative cancer therapy. A critical review and economic analysis. J Gen Intern Med. 1997;12(5):318-331. |
Review/Other-Dx |
N/A |
To review (1) basic principles of follow-up in patients who are in complete remission following curative therapy for cancer; (2) evaluate the available data on follow-up strategies for testicular cancer, Hodgkin's disease, non-Hodgkin's lymphoma, breast cancer, colorectal cancer, small cell and non-small cell lung cancer, and prostate cancer; and (3) analyze the cost of follow-up strategies. |
According to the currently available literature, repetitive follow-up laboratory and radiologic testing, except for nonseminomatous germ cell tumors, does not detect the vast majority of cancer relapses, nor does it result in a greater chance of cure or prolonged survival. The majority of recurrences at all disease sites will first be recognized as symptomatic changes in the patient's condition or alterations in the physical examination. A limited panel of blood tests and radiographic studies to detect recurrences, metachronous disease, and complications of therapy (malignant and nonmalignant), will suffice for most cancers. Though data are limited, this more restrictive policy of follow-up testing does not appear to adversely impact patient quality of life and result in dramatic cost of savings to the health care system. |
4 |
| 66. Stone WZ, Wymer DC, Canales BK. Fluorodeoxyglucose-positron-emission tomography/computed tomography imaging for adrenal masses in patients with lung cancer: review and diagnostic algorithm. J Endourol 2014;28:104-11. |
Review/Other-Dx |
2 patients |
To review the accuracy of FDG-PET/CT to predict adrenal gland metastasis, explain the causes for false-positive PET, and provide a diagnostic algorithm. |
Both patients underwent transabdominal laparoscopic adrenalectomy and were found to have nodular hyperplasia without evidence of adrenal tumor. A total of seven articles containing 343 patients were identified as having pertinent oncologic information for NSCLC patients with adrenal lesions. Sensitivity and specificity of PET/CT for distant metastasis was 94% and 85%, respectively, but only 13% (44/343) of these patients had histologically confirmed adrenal diagnoses. Based on this, a diagnostic algorithm was created to aid in decision making. |
4 |
| 67. Yang RM, Li L, Wei XH, et al. Differentiation of central lung cancer from atelectasis: comparison of diffusion-weighted MRI with PET/CT. PLoS One 2013;8:e60279. |
Observational-Dx |
38 patients |
To assess the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiation of central lung cancer from atelectasis. |
PET/CT and DW-MR allowed differentiation of tumor and atelectasis in all 38 cases, but T2WI did not allow differentiation in 9 cases. Comparison of conventional T2WI and DW-MRI indicated a higher contrast noise ratio of the central lung carcinoma than the atelectasis by DW-MRI. ADC maps indicated significantly lower mean ADC in the central lung carcinoma than in the atelectasis (1.83±0.58 vs. 2.90±0.26 mm(2)/s, p<0.0001). ADC values of small cell lung carcinoma were significantly greater than those from squamous cell carcinoma and adenocarcinoma (p<0.0001 for both). |
2 |
| 68. Usuda K, Iwai S, Funasaki A, et al. Diffusion-weighted magnetic resonance imaging is useful for the response evaluation of chemotherapy and/or radiotherapy to recurrent lesions of lung cancer. Transl Oncol 2019;12:699-704. |
Observational-Dx |
41 patients |
To compare the response evaluation of DWI for chemotherapy and/or radiotherapy to recurrent tumors of lung cancer with that of CT which is a standard tool in RECIST (Response Evaluation Criteria in Solid Tumours) |
The response evaluation by CT using RECIST were PR in five patients, SD in two, and PD in the remaining 17 patients. On the other hand, the response evaluation by DWI were CR in four patients, PR in two patients, SD in one, and PD in the remaining 17 patients. Follow-up studies revealed the response evaluation by DWI were correct. Functional evaluation of DWI is better than that of CT for the response evaluation of chemotherapy and/or radiotherapy to recurrent tumors of lung cancer. |
2 |
| 69. Schoenmaekers J, Hofman P, Bootsma G, et al. Screening for brain metastases in patients with stage III non-small-cell lung cancer, magnetic resonance imaging or computed tomography? A prospective study. Eur J Cancer. 115:88-96, 2019 07. |
Observational-Dx |
N/A |
To evaluate the additive value of MRI after dCE-CT, incorporated in the 18FDG-PET-CE-CT |
Sixteen (7%) patients with extracranial stage III had BM on dCE-CT and were excluded. One hundred forty-nine patients were enrolled. 7/149 (4.7%) had BM on MRI without suspect lesions on dCE-CT. One hundred eighteen patients had a follow-up of at least 1 year (four with BM on baseline MRI); eight of the remaining 114 (7%) patients developed BM = 1 year after a negative staging brain MRI. |
2 |
| 70. Onn A, Vaporciyan A, Chang J, Komaki R, Roth J, Herbst R. Cancer of the lung. In: Kufe DW, Bast, R. Jr, Hait, WN, et al, ed. Cancer medicine. Hamilton, Ont, Canada: American Association for Cancer Research; 2006:1179–224. |
Review/Other-Dx |
N/A |
To discuss the review of the cancer of the lung. |
No results stated in the abstract |
4 |
| 71. Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM. Bronchopulmonary neuroendocrine tumors. Cancer 2008;113:5-21. |
Review/Other-Dx |
N/A |
To provide a broad overview on Bronchopulmonary neuroendocrine tumors (BP-NETs) and focuses on the evolution of the disease, general features, and current diagnostic and therapeutic options. |
No results stated in the abstract. |
4 |
| 72. Lu HY, Wang XJ, Mao WM. Targeted therapies in small cell lung cancer. Oncol Lett 2013;5:3-11. |
Review/Other-Dx |
N/A |
To discuss the review that focuses on targeted therapies in Small cell lung cancer (SCLC). |
No results stated in the abstract. |
4 |
| 73. Wu AJ, Gillis A, Foster A, et al. Patterns of failure in limited-stage small cell lung cancer: Implications of TNM stage for prophylactic cranial irradiation. Radiother Oncol 2017;125:130-35. |
Observational-Dx |
283 patients |
To hypothesize that TNM stage predicts brain metastasis risk and could inform the use of prophylactic cranial irradiation. |
Patients with stage I or II SCLC (35% of cohort) had significantly better survival and lower risk of distant and brain metastasis, compared with stage III patients. The 5-year cumulative incidence of brain metastasis for stage I/II and III were 12% and 26%, respectively. Stage had no correlation with local failure. On multivariate analysis, stage was independently prognostic for survival, distant metastasis risk, and brain metastasis risk. |
2 |
| 74. Brink I, Schumacher T, Mix M, et al. Impact of [18F]FDG-PET on the primary staging of small-cell lung cancer. Eur J Nucl Med Mol Imaging. 2004;31(12):1614-1620. |
Observational-Dx |
120 consecutive patients |
To evaluate the impact of FDG-PET on the primary staging of patients with SCLC. |
Sensitivity of FDG-PET was significantly superior to that of CT in the detection of extrathoracic lymph node involvement (100% vs 70%, specificity 98% vs 94%) and distant metastases except to the brain (98% vs 83%, specificity 92% vs 79%). However, FDG-PET was significantly less sensitive than cranial MRI/CT in the detection of brain metastases (46% vs 100%, specificity 97% vs 100%). The introduction of FDG-PET in the diagnostic evaluation of SCLC will improve the staging results and affect patient management, and may reduce the number of tests and invasive procedures. |
2 |
| 75. Antoniou AJ, Marcus C, Tahari AK, Wahl RL, Subramaniam RM. Follow-up or Surveillance (18)F-FDG PET/CT and Survival Outcome in Lung Cancer Patients. J Nucl Med 2014;55:1062-8. |
Observational-Dx |
261 patients |
To evaluate the added value of follow-up PET/CT to the clinical assessment and survival outcome of lung cancer patients. |
Of the 488 PET/CT scans, 281 were positive and 207 negative for recurrence. Overall median survival from the time of the PET/CT study was 48.5 mo. The median survival of PET-positive and PET-negative groups was 32.9 and 81.6 mo, respectively (P < 0.0001). A subgroup analysis demonstrated a similar difference in OS for 212 scans completed between 6 and 24 mo after treatment (P = 0.0004) and 276 scans completed after 24 mo (P = 0.0006). In the context of clinical assessment, PET/CT identified recurrence in 43.7% (107/245) of scans without prior clinical suspicion and ruled out recurrence in 15.2% (37/243) of scans with prior clinical suspicion. There was a significant difference in OS when grouped by clinical suspicion (P = 0.0112) or routine follow-up (P < 0.0001). In a multivariate Cox regression model, factors associated with OS were age (P < 0.0001) and PET/CT result (P = 0.0003). An age-stratified subgroup analysis demonstrated a significant difference in OS by PET scan result among patients younger than 60 y and between 60 and 70 y but not in those older than 70 y (P < 0.0001, P = 0.0004, and P = 0.8193, respectively). |
2 |
| 76. He YQ, Gong HL, Deng YF, Li WM. Diagnostic efficacy of PET and PET/CT for recurrent lung cancer: a meta-analysis. Acta Radiol. 55(3):309-17, 2014 Apr. |
Meta-analysis |
1035 patients(13 articles) |
To compare the diagnostic value of positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) using fluorine-18 deoxyglucose (18FDG) with conventional imaging techniques (CITs) for the detection of lung cancer recurrence. |
The pooled sensitivity (95% CI) for PET, PET/CT, and CITs were 0.94 (0.91-0.97), 0.90 (0.84-0.95), and 0.78 (0.71-0.84), respectively. The pooled specificity (95% CI) for PET, PET/CT, and CITs were 0.84 (0.77-0.89), 0.90 (0.87-0.93), and 0.80 (0.75-0.84), respectively. Regarding sensitivity, lower values were associated with CITs than PET (P = 0.000) and PET/CT (P = 0.005), and there was no significant difference between PET/CT and PET (P = 0.102). Regarding specificity, values for PET/CT and PET were significantly higher than for CITs (both P = 0.000), and there was no significant difference between PET/CT and PET (P = 0.273). In the SROC curves, a better diagnostic accuracy was associated with PET/CT than PET and CITs. |
Good |
| 77. Sheikhbahaei S, Mena E, Marcus C, Wray R, Taghipour M, Subramaniam RM. 18F-FDG PET/CT: Therapy Response Assessment Interpretation (Hopkins Criteria) and Survival Outcomes in Lung Cancer Patients. J Nucl Med. 57(6):855-60, 2016 06. |
Observational-Dx |
201 patients |
To evaluate the value of an (18)F-FDG PET/CT-based interpretation system (Hopkins criteria) to assess the therapy response and survival in lung cancer. |
Overall, the PET/CT studies were positive in 144 (71.6%) and negative in 57 (28.4%) patients. There was substantial agreement between 2 interpreters (R1, R2), with a ? of 0.78 (P < 0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Hopkins scoring system were 89%, 80%, 92.8%, 71.4%, and 86.7%, respectively. Overall, PET/CT resulted in starting a new treatment plan in 70.8% of patients with positive residual disease on therapy assessment PET/CT. There was a significant difference in overall survival (OS) between patients who were categorized as positive in comparison to those who were categorized as negative (hazard ratio [HR] = 2.12; 95% confidence interval = 1.44-3.12), which remained significant after adjustment for disease stage, prior clinical suspicion, and primary treatment. Subgroup analysis according to the tumor histology showed that positive Hopkins scoring could significantly predict the OS in both small cell lung cancer (HR = 2.88; log-rank, P = 0.02) and non-small cell lung cancer (HR = 2.01; log-rank, P = 0.001). Similarly, there was a significant difference in OS between patients with positive and negative Hopkins score both in those who had surgical resection as part of the primary treatment (HR = 6.09; log-rank, P < 0.001) and in those who were treated with chemotherapy with or without radiation (HR = 1.60; log-rank, P = 0.02). |
2 |
| 78. Seute T, Leffers P, ten Velde GP, Twijnstra A. Detection of brain metastases from small cell lung cancer: consequences of changing imaging techniques (CT versus MRI). Cancer. 2008;112(8):1827-1834. |
Observational-Dx |
481 consecutive patients |
To show 1) the effect of changing from CT to MRI on the prevalence of detected brain metastases in patients with newly diagnosed small cell lung cancer; 2) the difference in survival between patients with single and multiple brain metastases; and 3) the effect of the change in patient labeling on eligibility for prophylactic brain irradiation. |
The prevalence of detected brain metastases was 10% in the CT era and 24% in the MRI era. In the CT era, all detected brain metastases were symptomatic, whereas in the MRI era, 11% were asymptomatic. In both periods, patients labeled as single brain metastases survived longer than those labeled as multiple brain metastases. For patients labeled as single brain metastases or multiple brain metastases, survival was longer in the MRI era than in the CT era. The proportion of patients who were eligible for prophylactic cranial irradiation was lower in the MRI era. |
3 |
| 79. National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Committee on National Statistics; Committee on Measuring Sex, Gender Identity, and Sexual Orientation. Measuring Sex, Gender Identity, and Sexual Orientation. In: Becker T, Chin M, Bates N, eds. Measuring Sex, Gender Identity, and Sexual Orientation. Washington (DC): National Academies Press (US) Copyright 2022 by the National Academy of Sciences. All rights reserved.; 2022. |
Review/Other-Dx |
N/A |
Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. |
No abstract available. |
4 |
| 80. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
