Small Cell Lung Cancer
Small Cell Lung Cancer
We retrospectively reviewed records of 59 consecutive patients diagnosed with SCLC between 2004 and 2008 at a tertiary referral center and determined that 45 of these patients had received the majority of their care at the study center and had sufficient radiographic, diagnostic, treatment, and follow-up data to be included in our analysis. Clinical evaluations were not coordinated through a multidisciplinary thoracic oncology clinic. The primary measures of our study were time from first abnormal radiograph to diagnosis, time from first abnormal radiograph to treatment, and survival. The initial interpretation provided by the clinical radiologist was used to identify the first abnormal radiograph in this study. Time of diagnosis was the date of pathologically confirmed disease on a biopsy specimen. Time of treatment was the first date that chemotherapy was administered.
Chest CT was reviewed retrospectively by an experienced chest radiologist (L.D.) to distinguish radiographic features, including location (central vs peripheral) and margin of the lesion (smooth, lobulated, irregular, or spiculated). The tumor was characterized as peripheral if the primary tumor appeared to be in the peripheral one-third of the lung parenchyma, whereas hilar, perihilar, and mid-lung lesions were categorized as central. Attenuation of the lesion was assessed on standard soft tissue windows with window width set between 350 and 450 HU and level (center) at a point between 0 and 50 HU (width 350–450 HU, length 0–50 HU).
Statistical analysis was performed using the log rank test to investigate the effect of race, disease stage, site of clinical evaluation, and tumor location on time to diagnosis, time to treatment, and survival (SAS version 9.2; SAS Institute, Cary, NC). This study was approved by the investigational review board of the Ochsner Clinic Foundation.
Methods
We retrospectively reviewed records of 59 consecutive patients diagnosed with SCLC between 2004 and 2008 at a tertiary referral center and determined that 45 of these patients had received the majority of their care at the study center and had sufficient radiographic, diagnostic, treatment, and follow-up data to be included in our analysis. Clinical evaluations were not coordinated through a multidisciplinary thoracic oncology clinic. The primary measures of our study were time from first abnormal radiograph to diagnosis, time from first abnormal radiograph to treatment, and survival. The initial interpretation provided by the clinical radiologist was used to identify the first abnormal radiograph in this study. Time of diagnosis was the date of pathologically confirmed disease on a biopsy specimen. Time of treatment was the first date that chemotherapy was administered.
Chest CT was reviewed retrospectively by an experienced chest radiologist (L.D.) to distinguish radiographic features, including location (central vs peripheral) and margin of the lesion (smooth, lobulated, irregular, or spiculated). The tumor was characterized as peripheral if the primary tumor appeared to be in the peripheral one-third of the lung parenchyma, whereas hilar, perihilar, and mid-lung lesions were categorized as central. Attenuation of the lesion was assessed on standard soft tissue windows with window width set between 350 and 450 HU and level (center) at a point between 0 and 50 HU (width 350–450 HU, length 0–50 HU).
Statistical analysis was performed using the log rank test to investigate the effect of race, disease stage, site of clinical evaluation, and tumor location on time to diagnosis, time to treatment, and survival (SAS version 9.2; SAS Institute, Cary, NC). This study was approved by the investigational review board of the Ochsner Clinic Foundation.
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