Critical appraisal:Hiroaki Toba, Shoji Sakiyama, Hideki Otsuka, Yukikiyo Kawakami, Hiromitsu Takizawa, Koichiro Kenzaki, Kazuya Kondo,vand Akira Tangokua

This appraisal has been completed.

Article: Hiroaki Toba, Shoji Sakiyama, Hideki Otsuka, Yukikiyo Kawakami, Hiromitsu Takizawa, Koichiro Kenzaki, Kazuya Kondo,vand Akira Tangokua. 18F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in postoperative follow-up of asymptomatic non-small-cell lung cancer patients. Interact Cardiovasc Thorac Surg. ;15(5): 859–864. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480619/.

Assigned to

User:Rishendran.naidoo

Topic area

Guidelines:Lung cancer/Prevention and diagnosis

Clinical question

What are the optimal follow-up tests for people with lung cancer who have had curative intent treatment?

Form: Form:Critical appraisal

Study design: case series
Level of Evidence: IV

Section below only relevant for Cancer Council Project Officer

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Critical Appraisal

Article being appraised

Hiroaki Toba, Shoji Sakiyama, Hideki Otsuka, Yukikiyo Kawakami, Hiromitsu Takizawa, Koichiro Kenzaki, Kazuya Kondo,vand Akira Tangokua. 18F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in postoperative follow-up of asymptomatic non-small-cell lung cancer patients. Interact Cardiovasc Thorac Surg. ;15(5): 859–864. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480619/.

Applicable clinical question

What are the optimal follow-up tests for people with lung cancer who have had curative intent treatment?

Key Facts

Study Design

case series

Study aims:

Evaluate the performance of CT/PET in asymptomatic lung cancer patients following curative surgery

Number of Patients:

101

stage I-IIIA patients.

5yr follow up.
PET done alternating with CT every 6months for 3yrs and then annually for 2yrs.

Patients underwent brain MRI every 12months

Reported outcome(s):

recurrence rates
Disease free interval
Sensitivity, specificity, positive and negative predictive values
Survival following recurrence

Results of outcome(s):

18(18%) recurrence
Median disease free interval 25.6months (3-42)
Sensitivity 94.4%
Specificity 97.6%
PPV 89.5% NPV 98.8%
Accuracy 97%
Median survival following recurrence 25.2 +-15months
1yr survival 83.3%, 2yr = 69.9%

Comments on results:

Only 2 patients detected could undergo further surgery - mainly chemo or observation

Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias

High risk of bias

Comments: very selected group of patients

Show/Hide Risk of bias assessment

Risk of bias assessment: case series

Subject selection:

Highly selected or not described (e.g. single-institution study)

Were the outcome measures blind to pre/post-intervention?

No, but objective measures used

Follow-up complete and all patients included in the analysis?

Yes (follow-up >95%)

Size of effect

5	Reason for decision: No control group and therefore no comparison with CI or p values

Relevance of evidence

5	Additional comments: reports sensitivity and specificity

Result of appraisal

Included

Completed by

Dr Rishendran Naidoo MBCHB FC Cardio (SA), MMED, FRACS