Positron emission tomography and improved survival in patients with lung cancer: The Will Rogers phenomenon revisited

Karen G. Chee, Danh V. Nguyen, Monica Brown, David R Gandara, Theodore Wun, Primo N Lara

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Background: The Will Rogers phenomenon occurs when newer technology allows for more sensitive detection of tumor spread, resulting in stage migration and an apparent improvement in patient survival. We investigated whether use of highly sensitive positron emission tomography (PET) scanning in non-small cell lung cancer has had this effect. Methods: We performed a retrospective analysis involving 12 395 patients with non-small cell lung cancer in the pre-PET (1994-1998) and PET (1999-2004) periods. Interperiod differences in staging procedures, clinical variables, and patient survival were evaluated. Results: There was a 5.4% decline in the number of patients with stage III disease and an 8.4% increase in the umber of patients with stage IV disease in the PET period, corresponding with an increase in PET use from 6.3% to 20.1% (P<.001). The PET period predicted better survival with a hazard ratio (HR) of 0.95 (95% confidence interval [CI], 0.91-0.99) (P=.02). Use of PET was independently associated with better survival in patients with stage III (HR, 0.77; 95% CI, 0.69-0.85) and stage IV (HR, 0.64; 95% CI, 0.58-0.70) disease, but not those with stage I or II disease. Conclusion: These data support the notion that stage migration is responsible at least in part for an apparent improvement in survival for patients with stage III and IV non-small cell lung cancer in the PET scan era.

Original languageEnglish (US)
Pages (from-to)1541-1549
Number of pages9
JournalArchives of Internal Medicine
Volume168
Issue number14
DOIs
StatePublished - Jul 28 2008

Fingerprint

Positron-Emission Tomography
Lung Neoplasms
Survival
Non-Small Cell Lung Carcinoma
Confidence Intervals
Technology
Neoplasms

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Positron emission tomography and improved survival in patients with lung cancer : The Will Rogers phenomenon revisited. / Chee, Karen G.; Nguyen, Danh V.; Brown, Monica; Gandara, David R; Wun, Theodore; Lara, Primo N.

In: Archives of Internal Medicine, Vol. 168, No. 14, 28.07.2008, p. 1541-1549.

Research output: Contribution to journalArticle

@article{e9d4625870904358bfa5fc745554db50,
title = "Positron emission tomography and improved survival in patients with lung cancer: The Will Rogers phenomenon revisited",
abstract = "Background: The Will Rogers phenomenon occurs when newer technology allows for more sensitive detection of tumor spread, resulting in stage migration and an apparent improvement in patient survival. We investigated whether use of highly sensitive positron emission tomography (PET) scanning in non-small cell lung cancer has had this effect. Methods: We performed a retrospective analysis involving 12 395 patients with non-small cell lung cancer in the pre-PET (1994-1998) and PET (1999-2004) periods. Interperiod differences in staging procedures, clinical variables, and patient survival were evaluated. Results: There was a 5.4{\%} decline in the number of patients with stage III disease and an 8.4{\%} increase in the umber of patients with stage IV disease in the PET period, corresponding with an increase in PET use from 6.3{\%} to 20.1{\%} (P<.001). The PET period predicted better survival with a hazard ratio (HR) of 0.95 (95{\%} confidence interval [CI], 0.91-0.99) (P=.02). Use of PET was independently associated with better survival in patients with stage III (HR, 0.77; 95{\%} CI, 0.69-0.85) and stage IV (HR, 0.64; 95{\%} CI, 0.58-0.70) disease, but not those with stage I or II disease. Conclusion: These data support the notion that stage migration is responsible at least in part for an apparent improvement in survival for patients with stage III and IV non-small cell lung cancer in the PET scan era.",
author = "Chee, {Karen G.} and Nguyen, {Danh V.} and Monica Brown and Gandara, {David R} and Theodore Wun and Lara, {Primo N}",
year = "2008",
month = "7",
day = "28",
doi = "10.1001/archinte.168.14.1541",
language = "English (US)",
volume = "168",
pages = "1541--1549",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "14",

}

TY - JOUR

T1 - Positron emission tomography and improved survival in patients with lung cancer

T2 - The Will Rogers phenomenon revisited

AU - Chee, Karen G.

AU - Nguyen, Danh V.

AU - Brown, Monica

AU - Gandara, David R

AU - Wun, Theodore

AU - Lara, Primo N

PY - 2008/7/28

Y1 - 2008/7/28

N2 - Background: The Will Rogers phenomenon occurs when newer technology allows for more sensitive detection of tumor spread, resulting in stage migration and an apparent improvement in patient survival. We investigated whether use of highly sensitive positron emission tomography (PET) scanning in non-small cell lung cancer has had this effect. Methods: We performed a retrospective analysis involving 12 395 patients with non-small cell lung cancer in the pre-PET (1994-1998) and PET (1999-2004) periods. Interperiod differences in staging procedures, clinical variables, and patient survival were evaluated. Results: There was a 5.4% decline in the number of patients with stage III disease and an 8.4% increase in the umber of patients with stage IV disease in the PET period, corresponding with an increase in PET use from 6.3% to 20.1% (P<.001). The PET period predicted better survival with a hazard ratio (HR) of 0.95 (95% confidence interval [CI], 0.91-0.99) (P=.02). Use of PET was independently associated with better survival in patients with stage III (HR, 0.77; 95% CI, 0.69-0.85) and stage IV (HR, 0.64; 95% CI, 0.58-0.70) disease, but not those with stage I or II disease. Conclusion: These data support the notion that stage migration is responsible at least in part for an apparent improvement in survival for patients with stage III and IV non-small cell lung cancer in the PET scan era.

AB - Background: The Will Rogers phenomenon occurs when newer technology allows for more sensitive detection of tumor spread, resulting in stage migration and an apparent improvement in patient survival. We investigated whether use of highly sensitive positron emission tomography (PET) scanning in non-small cell lung cancer has had this effect. Methods: We performed a retrospective analysis involving 12 395 patients with non-small cell lung cancer in the pre-PET (1994-1998) and PET (1999-2004) periods. Interperiod differences in staging procedures, clinical variables, and patient survival were evaluated. Results: There was a 5.4% decline in the number of patients with stage III disease and an 8.4% increase in the umber of patients with stage IV disease in the PET period, corresponding with an increase in PET use from 6.3% to 20.1% (P<.001). The PET period predicted better survival with a hazard ratio (HR) of 0.95 (95% confidence interval [CI], 0.91-0.99) (P=.02). Use of PET was independently associated with better survival in patients with stage III (HR, 0.77; 95% CI, 0.69-0.85) and stage IV (HR, 0.64; 95% CI, 0.58-0.70) disease, but not those with stage I or II disease. Conclusion: These data support the notion that stage migration is responsible at least in part for an apparent improvement in survival for patients with stage III and IV non-small cell lung cancer in the PET scan era.

UR - http://www.scopus.com/inward/record.url?scp=49449085251&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=49449085251&partnerID=8YFLogxK

U2 - 10.1001/archinte.168.14.1541

DO - 10.1001/archinte.168.14.1541

M3 - Article

C2 - 18663166

AN - SCOPUS:49449085251

VL - 168

SP - 1541

EP - 1549

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 14

ER -