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Prognostic significance of standardised uptake value (SUVmax) measured on 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with small cell lung cancer

&NA; Certain prognostic factors for small cell lung cancer (SCLC) have been validated, but the prognostic role of 18F‐FDG PET/CT still remains unclear. The aim of this study was to evaluate the prognostic significance of 18F‐FDG PET/CT in patients with SCLC. We reviewed 142 patients with pathologically proven SCLC who underwent pre‐treatment 18F‐FDG PET/CT. Standardised uptake value (SUVmax) and other potential prognostic variables were chosen for analysis. The mean age of the study population was 58.2 ± 10.1 years (range, 25‐84), and 124 (87.3%) patients were men. The median SUVmax value was 11.6 (4.0‐29.3). Among the variables included in the univariate analysis, performance status (P = 0.001), disease stage (P < 0.001), administration of thoracic radiotherapy (TRT; P < 0.001), albumin level (P = 0.030) and LDH level (P < 0.001) showed prognostic significance. Further, multivariate analysis showed that performance status (P = 0.007), albumin level (P = 0.002), LDH level (P < 0.001) and administration of TRT (P = 0.001) were independent prognostic factors for survival. In conclusion, performance status, TRT, LDH level and albumin level were identified as important prognostic factors, while 18F‐FDG PET/CT uptake of the primary lesions did not have any prognostic significance for survival in patients with SCLC.

Use of FDG PET/CT in Patients with Pancoast Tumors: Does It Add Any Contribution to Patient Management?

PURPOSE To evaluate any potential value of 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography/computerized tomography (FDG PET/CT) in staging of patients with Pancoast tumors and to investigate the relationship between volume-based quantitative PET parameters and prognosis. MATERIALS AND METHODS The authors retrospectively reviewed data of the 47 patients with Pancoast tumors who underwent initial staging by conventional imaging methods and FDG PET/CT. FDG-PET images were visually and quantitatively evaluated, and metabolic tumor volume (MTV), total lesion glycolysis, and maximum standardized uptake values of primary tumors were calculated. The correlations between quantitative PET parameters and tumor stages, as well as overall survival, were analyzed. RESULTS By detecting unknown distant metastasis, PET/CT upstaged 21% of patients. The sensitivity and specificity for detection of lymphatic involvement were 100% and 83.75%, respectively. Having surgery (p = 0.01) and being at an early stage (p = 0.004) were the most predictive factors for overall survival. Although there was no significant correlation between quantitative PET parameters and overall survival, MTV was the most powerful discriminator for operability and preoperative staging (p < 0.05). CONCLUSIONS FDG-PET imaging was found to be a valuable method for an accurate staging in the management of patients with Pancoast tumor. Having surgery and being at an early stage at presentation were found to be significant predictors for survival. Quantitative metabolic parameters may contribute to clarification of operable patient subgroups having an early disease stage with low MTV.

EGFR, KRAS, and BRAF mutational profiles of female patients with micropapillary predominant invasive lung adenocarcinoma

Background/aim: This study aimed to analyze EGFR, KRAS, and BRAF mutations in females with micropapillary predominant invasive lung adenocarcinoma and their relationships with immunohistochemical and clinicopathological patterns.Materials and methods: A total of 15 females with micropapillary lung adenocarcinoma were selected. Mutational analysis of the EGFR, KRAS, and BRAF genes was carried out. Information regarding the demographic data, tumor size, treatment, and survival time for each patient was collated, and the predominant cell type, secondary architectural growth patterns, psammoma bodies, necrosis, and visceral pleural and angiolymphatic invasions were evaluated.Results: We identified EGFR mutation in six cases, KRAS mutation in three cases, and BRAF mutation in one case. EGFR, c-kit, VEGFR, and bcl-2 positivity was observed in ten, seven, four, and six cases, respectively. All cases were positive for VEGF (strong positivity in 11 cases and weak positivity in four cases) and bcl-2 (strong positivity in nine cases and weak positivity in six cases). Seven (46.6%) cases were positive for c-kit and 10 (66.6%) cases were positive for EGFR. Conclusion: EGFR mutation occurred at a higher incidence rate in micropapillary predominant invasive adenocarcinoma than has previously been found in conventional lung adenocarcinomas. KRAS mutation was observed as having a similar frequency to what was previously observed, but the frequency of BRAF mutation was lower than previously reported.

Survival and prognostic factors of oligometastatic non-small cell lung carcinoma: A single center experience

Introduction: In patients without targeted-mutations platinum-based chemotherapy is still current treatment method with a median survival rates of 8-11 months. Patients with single side oligo-metastatic disease should be consider for curative aggressive therapies for both primary and metastatic sides for better survival (NCCN 2016). Method Totally 29 oligo-metastatic NSCLC (16 adenocarcinoma, 13 non-adenocarcinoma) patients was evaluated retrospectively. In addition to surgery concurrent and sequential chemo-radiotherapy (CRT) were accepted as curative approach. Results: 25 male and 4 female with median age 58. There were 9 patients in each group of surgery and chemoradiotherapy (CRT). Metastasectomy, SBRT and radiotherapy was performed for metastasis. Rest of individuals had systemic chemotherapy or supportive care. Median follow-up time was 14.7 months. Median overall survival (OS)was 35 months, progression-free survival (PFS) was 15.7 and survival after first progression (SAFP) was 15.7 months (Figure1 ). OS=37.4 months for surgery, 33.5 months for CRT, p>0.05, PFS=16.3 months for surgery, 15.6 months for CRT, p>0.05 and SFAP=17.2 months for surgery, 12.9 months for CRT, p>0.05. In univariate cox-regresson analyses increase in cT staging (23 months for T1-2 and 6.5 months for T3-4, p=0.01; HR (95%CI): 7.9 (1.5-41.2) and existance of treatment toxicity (19.3 vs 0.6 months, p=0.03; HR (95%CI): 8.46 (1.14-62.6) was related to poor SAFP (Figure 2). Synchronous type showed higher OS than metachronous (35.6 vs. 25.2 months p>0.05). Conclusion: Even oligometastasis means stage 4 disease in lung cancer, radically treated patients can have more than 2 years survival.

Radical Oncological Surgery and Adjuvan Therapy in Non- Small Cell Lung Cancer Patients over 70 years of Age.

BACKGROUND The incidence of lung cancer increases with age. Approximately 50% of non-small cell lung cancer (NSCLC) patients are over 70 years old. Because of the increasing elderly population, treatment approaches in this age group continue to be studied similar to groups of young people. MATERIALS AND METHODS In the current study, 26 patients who underwent radical surgery and adjuvan chemoradiation at Ataturk Chest Diseases and Chest Surgery Training and Research Hospital were evaluated retrospectively. RESULTS Of 21 patients (81%) were male and the average age was 74.4. Lobectomy was performed in 18 cases, pneumonectomy in 3, sleeve lobectomy in 3 and bilobectomy in 2. There was no perioperative or early period mortality. Overall survival was 24.5 months. CONCLUSIONS From our study, lung cancer surgery and adjuvant therapy can be performed safely with low morbidity in the elderly.