Abstract

We aimed to evaluate the role of whole body bone scintigraphy in preventing the unnecessary operations in early stage non-small cell lung carcinoma (NSCLC) patients evaluated clinically as operable without any clinical symptoms or laboratory abnormalities. Seventy five patients diagnosed as NSCLC in our clinic were prospectively enrolled in this study. A bone scintigraphy with 99-m MDF was performed to all the patients. In the case of any suspicion observed in bone scintigraphy and clinical symptom the patient were evaluated by plain radiographies and/or magnetic resonance imaging. Bone metastasis was found in 23 (30.6%) patients. There was a significant association between clinical complaints and bone metastasis (p<0,001). Bone metastasis was present in 85% (11 of 13) of the patients with clinical complaints. However, in the patients without clinical complaints the rate of bone metastasis was detected in 19% (12 of 62) of the patients. The rate of bone metastasis in patients without any clinical complaint or serum calcium level or alkaline phosphatase abnormalities was 12% (9 of 75 patients). In three out of nine patients metastasis was detected in other sites also and the other three of out nine patients were in the stage of III B. The other three patients were in operable stages (two cases stage IB, one case stage IIIA) and this account 10.3% (three of 29) of clinically operable patients. There was a significant association between bone metastasis and N (lymph node staging) status (p=0.004). There was a parallel increase between the lymph node staging and bone metastasis. In our study, the bone metastasis rate in operable patients without complaints or laboratory abnormalites was 10.3%. Therefore, the use of bone scintigraphy in the staging of clinical operable NSCLC may prevent the unnecessary surgical interventions (mediastinoscopy, thoracotomy).