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K. Li
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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.03-052 - The Effect of Rounding on Rate of Positive Results on CT Screening for Lung Cancer (ID 6095)
14:30 - 15:45 | Author(s): K. Li
- Abstract
Background:
Effective management of small pulmonary nodules to reduce frequency of false positives has been one of the most challenging issues to implementation of screening. Measurement of size is important as it determines whether a nodule is positive result and also whether growth has occurred. Lung-RADS v.1 guideline requires nodule measurement to be rounded to the nearest whole number, it is not specified whether individual length and width measures should also be rounded prior to rounding the diameter. An alternative approach is the one used in I-ELCAP where measurements were recorded to one decimal place. This study explored how rounding would affect the frequency of positive results both for baseline and annual rounds.
Methods:
Using data collected from CT screenings of 21,136 I-ELCAP participants, we evaluated four different approaches for calculating the nodule diameter (D) based on measurements of the length (L) and width (W) listed below: 1) Measurement of L and W to one decimal place (x.x) and calculation of D without rounding; 2) rounding D to the nearest integer; 3) rounding the L and W measurements to the nearest integer before calculating D with no further rounding; and 4) rounding the calculated D determined by method 3 to the nearest integer. Threshold of positive results was 6.0 mm for baseline round and 4.0 mm for annual repeat rounds of screening. Frequency of positive results in the baseline and annual repeat rounds were compared.
Results:
For baseline screening using the current I-ELCAP definition (Method 1), the rate of positive results was 10.2%. Using method 2, 3 and 4, positive rates were 12.8%, 10.5% and 13.2%, respectively. Use of rounding would have increased the frequency of positive results by 25.7%, 3.0%, and 28.9%, respectively. Of 85,877 repeat screenings, the rate of positive results was 8.0% using method 1. Using method 2, 3 and 4, positive rates were 9.7%, 8.3% and 9.8%, respectively. Use of rounding would have increased the frequency of positive results on repeat screenings by 20.5%, 3.2%, and 22.3%, respectively.
Conclusion:
Regardless of where the rounding occurred, it results in more nodules designated as positive. This effect is most pronounced when the rounding occurs in average diameter, and since frequency of nodules increases as size decreases, small nodules are therefore the most frequent cause for positive results and rounding can lead to large increases in positive rates.
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-071 - A Review of Quality of Life Measures Used in Lung Cancer Surgical Outcomes (ID 6175)
14:30 - 15:45 | Author(s): K. Li
- Abstract
Background:
With the increased life expectancy following surgery for early stage non-small-cell lung cancer (NSCLC), concern about the quality of life (QoL) of patients after surgery has gained attention. Previous QoL studies were limited by small sample size, inclusion of late-stage cancers and non-surgical treatments. This review summarized the existing literature on QoL in early stage lung cancer patients who underwent surgical treatment.
Methods:
PubMed and PsycINFO were searched for articles published between 1995 (year of the last published meta-analysis) and March 21, 2016. All English articles reported on quality of life for Stage I NSCLC were included. Data extraction was performed by two independent reviewers using pre-specified criteria.
Results:
Ten articles from nine studies were identified. Of the nine studies, four reported on the SF-36, one on the SF-12, one on the EORTC QLQ-C30, one on POMS-TMD, one on EQ-5D, and one on SGRQ. One study reported only on pre-surgical QoL, six only on post-surgical QoL and two studies reported on both pre- and post- surgical QoL. Timing for the administration of post-surgical QoL survey varied, from time at discharge to up to six years post-surgery. Two studies included only NSCLC patients with COPD. Due to the heterogeneity of these studies, comparison between studies and traditional meta-analysis were not possible.
Conclusion:
The literature on QoL in Stage I NSCLC patients is very sparse. As CT screening for lung cancer becomes more widespread with a consequent shift from late to early stage NSCLC, additional research is needed to explore the impact of different NSCLC surgical approaches on QoL.
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P1.05-073 - Evaluation of Stage 1 Sub-Solid Lung Nodules Using PET Imaging (ID 4287)
14:30 - 15:45 | Author(s): K. Li
- Abstract
Background:
Positron emission tomography (PET) scans are valuable in the evaluation of lung nodules. Subsolid (SS:<80% solid) lung nodules, however, often have low levels of metabolic activity and rare metastases. The purpose is to assess PET in the evaluation of SS nodules.
Methods:
Between 2009-2015, 892 patients had a chest computed tomography (CT) with a SS finding and PET within 6 months, with pathology specimen, at our institution. 50 patients had clinical stage IA/B lung cancer and were retrospectively analyzed. CT analysis further classified these subsolid lesions as nonsolid(NS) and part-solid(PS).
Results:
26 patients had NS nodules and 24 PS. Mean maximal tumor dimension was not statistically significantly different between the groups (mean±SD; NS- 16.8±6.9; PS- 16.9±6.2). PET positive nodules (SUV>2.5) were larger in maximal tumor dimension than PET negative on CT though the difference was not statistically significant (mean±SD; PET Neg, n=42- 16.1±5.7; PET-pos, n=8- 20.9±8.8). Among the 39 patients in which lymph node pathology was obtained, sensitivity and specificity of PET in identifying N1 disease was 0% and 92.9%; and 0% and 100% for N2 disease. Recurrence and overall survival were 0% and 100%, with median follow-up of 34 months. Figure 1
Conclusion:
The use of PET for the evaluation of SS nodules in stage I lung cancer may have limited value in detecting metastases and affecting current clinical decision making for these patients.
