Extrapulmonary malignancy as a cause of mortality in the NLST
Principal Investigator
Name
Myrna Godoy
Degrees
MD PhD
Institution
MD Anderson Cancer Center - The University of Texas
Position Title
Associate Professsor
Email
About this CDAS Project
Study
NLST
(Learn more about this study)
Project ID
NLST-200
Initial CDAS Request Approval
Mar 30, 2016
Title
Extrapulmonary malignancy as a cause of mortality in the NLST
Summary
Summary:
The results from the National Lung Screening Trial (NLST) were published in August 2011 demonstrating that low-dose CT (LDCT) screening reduces lung cancer mortality by 20% compared with screening using chest radiography. The NLST also demonstrated a 6.7% decrease in overall mortality rate, possibly related to identification of incidental findings. The prevalence of extrapulmonary malignancies has been estimated in other lung cancer screening trials to range between 0.5 – 1.6% of cases. In the CT arm of the NLST, lung cancer represented 22.9% of the causes of death, whereas other neoplasms represented 22.3%. The specific types of other neoplasms causing mortality in the NLST have not been published to date.
The objective of this study is to evaluate the most common causes of mortality caused by extrapulmonary malignancies in the National Lung Screening Trial (NLST) population and to determine if these neoplasms were detectible at the time of LDCT screening during the NLST.
We will retrospectively identify the NLST patients who died from extrapulmonary malignancies. The available LDCT images from these patients at T0, T1 and T2 will be retrospectively reviewed by readers. Abnormal CT findings at each specific affected organ will be recorded. Results from the NLST readers will be reviewed by readers and will be regarded as a second reader. An experienced adjudicator will review any discrepancies between current reading and results from the original NLST reader. The percentage of fatal extrapulmonary cancers that were detectable at LDCT at the time of the NLST will be determined.
The results from the National Lung Screening Trial (NLST) were published in August 2011 demonstrating that low-dose CT (LDCT) screening reduces lung cancer mortality by 20% compared with screening using chest radiography. The NLST also demonstrated a 6.7% decrease in overall mortality rate, possibly related to identification of incidental findings. The prevalence of extrapulmonary malignancies has been estimated in other lung cancer screening trials to range between 0.5 – 1.6% of cases. In the CT arm of the NLST, lung cancer represented 22.9% of the causes of death, whereas other neoplasms represented 22.3%. The specific types of other neoplasms causing mortality in the NLST have not been published to date.
The objective of this study is to evaluate the most common causes of mortality caused by extrapulmonary malignancies in the National Lung Screening Trial (NLST) population and to determine if these neoplasms were detectible at the time of LDCT screening during the NLST.
We will retrospectively identify the NLST patients who died from extrapulmonary malignancies. The available LDCT images from these patients at T0, T1 and T2 will be retrospectively reviewed by readers. Abnormal CT findings at each specific affected organ will be recorded. Results from the NLST readers will be reviewed by readers and will be regarded as a second reader. An experienced adjudicator will review any discrepancies between current reading and results from the original NLST reader. The percentage of fatal extrapulmonary cancers that were detectable at LDCT at the time of the NLST will be determined.
Aims
Specific Aims:
To identify the most common causes of fatal extrapulmonary malignancies at the NLST.
To evaluate the extent to which LDCT screening for lung cancer allowed detection of extrapulmonary cancers that are responsible for patient’s death at NLST.
Collaborators
Dr. Caroline Chiles (Dr. Chiles was a site PI for ACRIN-NLST)
Wake Forest University Health Sciences Center
Dr. Charles S. White
University of Maryland Medical Center
Dr. Jeremy J. Erasmus
MD Anderson Cancer Center - The University of Texas
Dr. Myrna C. Godoy
MD Anderson Cancer Center - The University of Texas
Related Publications
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Extrapulmonary neoplasms in lung cancer screening.
Godoy MCB, White CS, Erasmus JJ, Wu CC, Truong MT, Munden RF, Chiles C
Transl Lung Cancer Res. 2018 Jun; Volume 7 (Issue 3): Pages 368-375 PUBMED