Is Routine Scanning Necessary for Detecting Extrathoracic Metastases in Patients with Non-small Cell Lung Cancer under Stage T1x?

• Main Authors: Hsien-Chi Liao, 廖先啟
• Other Authors: Kuo-Piao Chung
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/qwjw4w

碩士 === 國立臺灣大學 === 公共衛生碩士學位學程 === 105 === Abstract Background In recent years, statistics show that lung cancer is one of the cancers with higher incidence rates in Taiwan. Most patients are at terminal stage when diagnosed with lung cancer, so there is a high mortality rate. Although the overall prognosis is poor, the staging of lung cancer still has a major impact on its progression and treatment. Objectives As a thoracic surgeon, we are to screen lung cancer patients at their initial stage and to give them surgical treatment if possible. Many years of clinical work tells us that non-small cell lung cancer at initial stage rarely has distant metastasis. However, we now lack the direct evidence whether some scans are unnecessary at such low risks of metastases. Methods This study enrolled the non-small cell lung cancer cases in our lung cancer database at National Taiwan University Hospital from 2005 to 2015. Then, we analyzed the metastasis rates to brain, bone and other distant locations of these tumors with diameters less than 3 cm. By interpreting the risk ratios and the ascending trend lines, we discussed the necessity of some routinely performed whole body scans and the risk factors associated with metastases. Results For non-small cell lung cancers smaller than 1 cm, there was almost no brain or bone metastasis. Thus, there is no need for brain and bone scans. However, scans are suggested for those non-small cell lung cancers greater than 1 cm, as they have growing rates of metastases. There are 3 expected contributions of this study: 1.To answer the clinical question that in what conditions, patients of non-small cell lung cancers can neglect non-chest scanning. This will save money, time and energy expenditure. 2.To find the risk factors for distant metastases for non-small cell lung cancers with small sizes. 3.To establish a definition of high risk group for future large sample sized lung cancer screening. Key Words non-small cell lung cancer, lung cancer staging, brain metastasis.