WASHINGTON, Sept. 13 (UPI) -- A new study shows imaging techniques are more accurate than surgery for lung cancer staging but have no effect on extending survival after diagnosis.
Five-year survival was the same among patients who underwent endosonography and mediastinoscopy for lung cancer staging, despite improvements to the imaging procedure, surprising researchers at the Academic Research Center in Amsterdam.
Staging procedures allow doctors to select the proper course of treatment for cancer patients. The more accurate the procedures are, the better treatment may turn out for patients -- at least, that's the theory.
For the study, published in the journal JAMA, the researchers recruited 241 patients at four clinics in the Netherlands, Belgium and England, randomly using endosonographic staging with 123 patients and surgical staging with 118 between 2007 and 2009.
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Although sensitivity to detect metastases was far more accurate with the imaging technique than surgery -- 94 percent for endosconography and 79 percent for surgery -- survival was relatively similar.
Mediastinal nodal metastases were detected in 54 percent of patients with endosonography and 44 percent in the surgery group, but survival five years after diagnosis was 35 percent for both. Median survival for the endosonographic strategy of detection was 31 months, compared to 33 months for surgery.
The study was designed to judge accuracy of the two staging procedures, of which endosonography is clearly preferable. While the lack of difference in survival was unexpected, the researchers say an explanation is unlikely to be sought because of preference for the less invasive procedure.
"If a survival difference exists between the strategies exists, it is likely to be small and a larger sample size may be needed to detect it," the researchers wrote. "However, randomized trials to detect a survival difference based on staging strategy are not likely to be conducted as the endosonographic strategy is now advised in clinical guidelines."
