Cheng Ya-Fu, Huang Jing-Yang, Lin Ching-Hsiung, Lin Sheng-Hao, Wang Bing-Yen
Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua 500, Taiwan.
Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
J Clin Med. 2024 Apr 21;13(8):2416. doi: 10.3390/jcm13082416.
The application of positron emission tomography/computed tomography (PET/CT) helps provide accurate clinical staging for lung cancer patients. However, the effects and trends in early-stage lung cancer remain unclear. The aim of this study was to compare differences between clinical stage I lung cancer patients who received PET/CT for staging and those who did not. Data were obtained from the Taiwan Society of Cancer Registry. There were 6587 clinical stage I lung cancer patients between 2009 and 2014 analyzed in this study. We compared the characteristics of the PET/CT and no PET/CT groups. After propensity score matching, it resulted in both groups having 2649 patients. We measured the overall survival rates of all clinical stage I lung cancer patients and the overall survival rates of patients with PET/CT and without PET/CT. The 1-, 3-, and 5-year survival rates of all clinical stage I lung cancer patients were 97.2%, 88.2%, and 79.0%, respectively. Patients with a larger tumor size tended to receive PET/CT for staging (stage Ib: 38.25% vs. 27.82%, < 0.0001) and a larger resection (lobectomy: 74.62% vs. 66.61%, < 0.0001). The 5-year survival rates were 79.8% in the PET/CT group and 78.2% in the no PET/CT group after propensity score matching ( = 0.6528). For clinical stage I lung cancer in Taiwan, patients with larger tumor sizes tend to have PET/CT for staging. Although PET/CT provided more precise clinical staging, these patients still received larger resections and had more pathological migration. However, there was no overall survival rate benefit after PET/CT.
正电子发射断层扫描/计算机断层扫描（PET/CT）的应用有助于为肺癌患者提供准确的临床分期。然而，早期肺癌的影响和趋势仍不明确。本研究的目的是比较接受PET/CT进行分期的临床I期肺癌患者与未接受PET/CT分期的患者之间的差异。数据来自台湾癌症登记协会。本研究分析了2009年至2014年间6587例临床I期肺癌患者。我们比较了PET/CT组和未行PET/CT组的特征。经过倾向评分匹配后，两组各有2649例患者。我们测量了所有临床I期肺癌患者的总生存率以及接受PET/CT和未接受PET/CT患者的总生存率。所有临床I期肺癌患者的1年、3年和5年生存率分别为97.2%、88.2%和79.0%。肿瘤体积较大的患者倾向于接受PET/CT进行分期（Ib期：38.25%对27.82%，<0.0001），且切除范围更大（肺叶切除术：74.62%对66.61%，<0.0001）。倾向评分匹配后，PET/CT组的5年生存率为79.8%，未行PET/CT组为78.2%（P = 0.6528）。对于台湾的临床I期肺癌患者，肿瘤体积较大的患者倾向于接受PET/CT进行分期。虽然PET/CT提供了更精确的临床分期，但这些患者仍接受了更大范围的切除，且有更多的病理转移。然而，PET/CT后总体生存率并无益处。
