Sarcoid Reaction in Primary Tumor of Bronchogenic Large Cell Carcinoma Accompanied with Massive Necrosis.

7571 Background: The routine preoperative use of PET/CT in patients with potentially resectable NSCLC is rapidly expanding. The SUVmax is a semiquantitative measure of metabolic activity that can distinguish benign from malignant tissue but published data are conflicting regarding its ability to discriminate between major histological subtypes. Methods: Pathology and PET/CT reports of 39 NSCLC patients who underwent a preoperative scan and curative resection at the McGill University Health Centre were reviewed. Only patients with Adenocarcinoma (AC), Squamous Cell carcinoma (SC), or Large Cell carcinoma (LC), and definitive pathological staging, were included. The SUVmax values for each histological subtype, along with primary tumor sizes, were compared using F test and t-test analyses. Results: The 15 patients with SC and 5 with LC histology were found to have significantly greater preoperative SUVmax values than the 19 patients with AC (mean 12.7 and 17.2 vs. 9.4, respectively, P < 0.05), despite the fact that no significant differences in tumor size were observed between histological subtypes. Patients with LC histology displayed higher SUVmax values than patients with SC histology, but this was not found to be significant (P = 0.057).Conclusions: These data suggest that SC pulmonary tumors have significantly greater uptake on PET/CT than AC tumors. This finding may be helpful in the future when sufficient tissue cannot be obtained for pathological diagnosis or to identify the predominant pathology of mixed tumors. Larger studies are required to confirm our results. [Table: see text] No significant financial relationships to disclose.

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The role of surgery in the management of selected patients with small-cell carcinoma of the lung.

Journal of Clinical Oncology ◽

10.1200/jco.1987.5.5.697 ◽

1987 ◽

Vol 5 (5) ◽

pp. 697-702 ◽

Cited By ~ 48

Author(s):

R R Baker ◽

D S Ettinger ◽

J D Ruckdeschel ◽

J C Eggleston ◽

M F McKneally ◽

...

Keyword(s):

Lymph Nodes ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Primary Tumor ◽

Residual Disease ◽

Large Cell Carcinoma ◽

Large Cell ◽

Small Cell ◽

Operative Specimen

This study was designed to evaluate the efficacy of surgical resection of the primary tumor and lymph nodes in patients with localized small-cell carcinoma who had responded to induction chemotherapy. The study was performed in 37 patients who received two cycles of chemotherapy consisting of cyclophosphamide, doxorubicin, and etoposide. Those patients who achieved a complete or partial (greater than 50%) response were evaluated for thoracotomy and the primary tumor and regional lymph nodes excised when feasible. Postoperatively, the patients received prophylactic cranial irradiation and were maintained on the same chemotherapy for an average of 11 months. Twelve patients were resected and found to have residual small-cell carcinoma in the operative specimen (ten) or no residual disease (two). Seven of these patients (58%) are alive without evidence of disease (median follow-up, 24 months). Seven other patients who were resected proved to have either residual foci or small-cell carcinoma mixed with adenocarcinoma or large-cell carcinoma (four) or only focal areas of adenocarcinoma, large-cell carcinoma, or squamous-cell carcinoma with no evidence of residual small-cell carcinoma. Five of these patients (71%) are alive without evidence of disease (median follow-up, 36 months). Two of the 16 patients who were not resected but treated with chemotherapy and radiation are alive at 15 and 31 months without evidence of disease, the other 14 are dead of disease.

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