Is there a role of whole body bone scan in early stages of non small cell lung cancer patients

Abstract

Purpose: The aim of our study was to re-evaluate the role of whole-body bone scanning (WBBS) in detecting bone metastases in apparently operable stages of non small cell lung cancer (NSCLC) patients.

Patients and methods: We made a retrospective analysis of 60 patients (53 males, 7 females, aged 47-87 years, mean 68+/-4) between 2004-2006. All patients had a full series of imaging staging procedures including WBBS. Their medical records were reviewed with respect to how often bone metastases were detected and whether or not the patients showed any symptoms or laboratory abnormalities indicating bone involvement.

Results: Skeletal metastases (confirmed afterwards by x-ray, computed tomography or biopsy) were found in 11 (18.3%) patients. All of them had normal serum alkaline phosphatase and calcium concentrations. Eleven patients had symptoms suggesting bone metastases and 49 were asymptomatic. Bone metastases were detected in 3 (27.2%) of 11 clinically symptom-positive patients and in 8 (16.3%) of 49 clinically symptom-negative patients.

Conclusion: The present study indicates that if bones scans were done only in patients reporting skeletal symptoms an important number of patients (16.3%) would have been misstaged due to asymptomatic bone metastases. We conclude that in patients with apparently operable NSCLC preoperative staging using WBBS is useful to avoid under-staging and futile surgery.