Integrated PET/CT in non small cell lung cancer staging - Clinical and pathological agreement [PET/TC no estadiamento do carcinoma pulmonar de não pequenas células - Concordância entre o estadiamento clínico e o patológico]

Introduction: integrated pet/ct has become a fundamental tool in the preoperative assessment of non small lung cancer (nsclc) providing useful anatomical and metabolic information to characterize tumoral lesions and to detect unsuspected metastatic disease. aim: to compare the agreement between clinical and pathological staging before and after the use of pet/ct. material and methods: retrospective study of patients with nsclc who underwent potentially curative surgery throughout 10.5 years. cohen's kappa coefficient was used to evaluate staging agreement. results: one hundred and fifty patients were evaluated,78% males,with a mean age of 65 (±9.6) years. thirteen percent were submitted to neo adjuvant chemotherapy. pet/ct was performed in 41%. global agreement between clinical and pathological staging was 51% (kappa=0.3639). there was a statistically significant difference between the staging results in patients who underwent pet/ct,when compared to the subgroup who did not (p=0.003). for those with pet/ct false negatives occurred in less 39%,false positives in more 12% and clinical and pathological staging coincided in more 27%. the overall results reflected an improvement in the agreement between clinical and pathological staging in the pet/ct subgroup (67%,kappa=0.5737 vs 40%,kappa=0.2292). pet/ct accuracy was enhanced when patients re-staged after neo adjuvant therapy were excluded and a substantial staging agreement was obtained for those who had the exam only for staging purposes (73%,kappa=0.6323). conclusion: inclusion of pet/ct in nsclc preoperative assessment improved the accuracy of the clinical staging,with a good level of agreement with pathological staging. © 2011 sociedade portuguesa de pneumologia. published by elsevier españa,s.l. all rights reserved.