Chest ACCP Career Connection
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Feld, R
Right arrow Articles by Murray, N
Right arrow Search for Related Content
PubMed
Right arrow Articles by Feld, R
Right arrow Articles by Murray, N

Chest, Vol 103, 1010-1016, Copyright © 1993 by American College of Chest Physicians

ARTICLES

The restaging of responding patients with limited small cell lung cancer. Is it really useful?

R Feld, J Pater, PJ Goodwin, R Grossman, P Coy and N Murray
Princess Margaret Hospital, Toronto, Ontario, Canada.

A retrospective review of data on patients entered on two limited small cell lung cancer studies of the National Cancer Institute of Canada (BR.3 and BR.6) was undertaken to determine the value of restaging and rebronchoscopy in responding patients. An economic evaluation was also done. Repeat scans (brain, liver) and bronchoscopy were carried out in 190 patients and 5 (2.6 percent) were positive, despite other evidence suggesting response. One hundred thirty-nine of 324 patients who achieved complete response on the two trials underwent rebronchoscopy. Among these, 122 (87.7 percent) were negative and eight (5.8 percent) were inconclusive. Nine (6.5 percent) were positive despite other evidence suggesting the patient had achieved a complete response. A small group of nine patients with positive rebronchoscopy survived for a shorter time than the group with negative or inconclusive rebronchoscopies. The survival difference was only statistically significant when analyzed using the log rank test, but it was not significant when analyzed by the Wilcoxon test. The economic analysis showed that it costs $11,333 per patient reclassified when scans were redone in these patients. The cost could even have been higher had we used present-day scanning techniques (computed tomography and magnetic resonance imaging), although they might be slightly more sensitive. The cost of rebronchoscopy per patient reclassified was $14,960. Therefore, we recommend that restaging (scans or rebronchoscopy) not be done in responding patients with limited small cell lung cancer, thus potentially saving health care dollars as well as reducing patient inconvenience with no detrimental effect on survival.


This article has been cited by other articles:


Home page
 J Natl Cancer Inst MonogrHome page
C. C. Earle
Outcomes Research in Lung Cancer
J Natl Cancer Inst Monographs, October 1, 2004; 2004(33): 56 - 77.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
British Thoracic Society, Society of Cardiothoracic Surgeons of Great Britai, and Ireland Working Party
Guidelines on the selection of patients with lung cancer for surgery
Thorax, February 1, 2001; 56(2): 89 - 108.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1993 by the American College of Chest Physicians.