• Oncology Clinical Trials
• Respiratory Cancers
• Radiology
• Cancer
• Radiation Therapy

• Oncology Clinical Trials
• Respiratory Cancers
• Radiology
• Cancer
• Oncology
• Radiation Therapy

Invasive mediastinal staging methods did not provide added outcome benefits over positron emission tomographic (PET) imaging alone in patients with non-small cell lung cancer (NSCLC). Roy Decker, MD, PhD, Yale University School of Medicine, New Haven, Connecticut, USA, presented data from this retrospective analysis.

Stereotactic body radiotherapy (SBRT) is a treatment option for patients with NSCLC who are not eligible for surgical intervention. The staging workup for patients with NSCLC receiving stereotactic SBRT requires an initial PET imaging. However, in some cases, nodal status is confirmed by mediastinoscopy or endobronchial ultra-sonography. The supplementary information obtained by these invasive mediastinal procedures has not been well studied in NSCLC. This study assessed whether additional staging improved outcomes in patients with NSCLC.

A total of 286 patients with early-stage NSCLC who received either PET-only (68%) or PET-plus-invasive mediastinal staging (32%) were included in the analysis. Patients with larger tumors (> 3 cm), synchronous primary lesions, and central lesions were more likely to receive PET-plus-invasive mediastinal staging. Survival distributions and hazard ratio analyses were completed in this assessment.

Overall survival (OS) for both groups was similar; median OS for PET-only patients was 26.8 months compared with 22.4 months in PET-plus-invasive mediastinal staging (P = .28). Both groups had similar rates of local recurrence-free survival (82.5% vs 89.6%), regional recurrence-free survival (89.5% vs 81.9%), and distant recurrence-free survival (78.2% vs 85.6%).

Neither pretreatment staging method was predictive of OS or recurrence-free survival. Regression analysis showed that staging method type, prior cancer, age, and the presence of synchronous tumors were not significant predictors of OS or recurrence-free survival (P > .05). However, central location (HR, 1.46) and advanced tumor stage (HR, 1.49) were factors that predicted worse OS (P < .05).

The authors concluded that because of the similar clinical outcomes, more invasive mediastinal staging might be unnecessary for patients with early-stage NSCLC receiving SBRT.

• © 2014 MD Conference Express®