PREOPERATIVE EVALUATION OF STAGE-I AND STAGE-II NONSMALL CELL LUNG-CANCER

The appropriate preoperative evaluation for occult metastasis in patie nts with potentially resectable lung cancer remains controversial. The records of 265 patients with stage I and II non-small cell lung cance rs who underwent resection with curative intent were reviewed to deter mine if there was a survival benefit of negative preoperative scanning to detect metastases. A minimum of 5 years of follow-up was possible for all long-term survivors. Patients having preoperative bone scans, brain imaging, and abdominal imaging had no increased survival over th ose without such evaluation (using Kaplan-Meier survival curves). Addi tionally, no difference was found in the time to first recurrence betw een these groups, and the site of recurrence was independent of a nega tive preoperative scan for that location. These data, using patient ou tcome as the basis of our conclusion, support a policy of reserving ex pensive preoperative metastatic evaluations only for those patients wi th clinical evidence of metastatic disease.