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Real-world data evaluating the value of PET-CT for mediastinal staging in patients diagnosed with non-small cell lung cancer in an area with high prevalence of granulomatous diseases: The LACOG-0114 study.

2017; Lippincott Williams & Wilkins; Volume: 35; Issue: 15_suppl Linguagem: Inglês

10.1200/jco.2017.35.15_suppl.e20065

1527-7755

Carlos Cézar Fritscher, Mara Lise Zanini, Eduardo Herz Berdichevski, Eduardo Vilas, Bruno Hochhegger, Vinícius Duval da Silva, J.A. Figueiredo Pinto, Leandro Genehr Fritscher, L Hartmann, Marcos Alba, Guilherme Sartori, Cristina Sebastião Matushita, Arthur Vieira, Vanessa Rezende Bortolotto, Rayssa Ruszkowski do Amaral, Facundo Zaffaroni, Jeovany Martínez-Mesa, Gustavo Werutsky, Carlos H. Barrios, Márcio Debiasi,

Lung Cancer Diagnosis and Treatment

e20065 Background: Evaluation of the mediastinum is critical for therapeutic decision in patients with operable non-small cell lung cancer. This analysis aims to evaluate specificity and positive predictive value (PPV) of PET-CT in mediastinal staging of patients diagnosed with NSCLC in South Brazil, an area with high prevalence of infectious granulomatous disease, such as tuberculosis (estimated incidence of 45 cases/100.000 and only 63.7% of cure rate) (http://www.saude.rs.gov.br/upload/1459169540_RELATÓRIO%20TUBERCULOSE%202016.pdf). Methods: Patients with stages I-III NSCLC underwent 18FDG PET-CT before invasive mediastinal staging. Different SUV cut-offs were evaluated, but for the purpose of this analysis were considered positive all PET-CTs showing any mediastinal uptake > 5 SUV. This abstract shows the specificity and the PPV associated with PET-CT when this high-uptake cut-of is considered. Results: From Aug/2014 to Aug/2016, 100 patients were enrolled, all treated at the Brazilian Public Health System, of which 85 were submitted to mediastinoscopy after PET-CT. Median age was 65 years (range 47-80). At baseline, 49 (58%) patients were male and 68 (80%) white. Current or former smokers accounted for 94% (80/85) of the sample. The prevalence of mediastinal involvement was 27% (23/85) confirmed by histopathological evaluation. PET-CT showed specificity of 79% (95% CI 67%–88%) and PPV of 54% (95% CI 40%–67%) when a SUV > 5 was used as cut-off for positivity (see table). Conclusions: These findings consolidate the clinical impression that a positive PET-CT does not confirm the diagnosis of mediastinal involvement in NSCLC patients treated in areas with high prevalence of infectious granulomatous diseases. In this scenario, all positive findings should be confirmed with histopathological evaluation to assure the diagnosis. Clinical trial information: NCT02664792. [Table: see text]