e19044 Background: (18)FDG-PET is not routinely used in the initial staging of SCLC despite evidence that it alters stage classification and management. Furthermore, the association between stage classification by PET and prognosis of newly diagnosed SCLC has not previously been directly assessed. We aimed to evaluate whether PET altered stage classification, management and prognosis when used to stage newly diagnosed SCLC. METHODS: We retrospectively reviewed the medical records of 46 consecutive patients undergoing PET during initial staging for SCLC at Austin Health from 1993 to 2008 inclusive. Data collected included patient demographics, stage classification before and after PET, treatment history and date of death. Statistical analysis included estimation of overall survival (OS) by the Kaplan-Meier method using the log-rank test. RESULTS: PET altered stage classification in 12 of 46 (26%) of patients. Stage alteration led to a change in treatment modality in 9 of these 12 patients. In addition, PET altered the target radiation field in another three patients. Therefore, PET had a significant impact on management in 12 of 46 (26%) of patients. Patients with limited disease (LD) on both conventional imaging and PET had significantly longer OS than patients with LD on conventional imaging that was upstaged to extensive disease (ED) on PET (median 557 days versus 172 days; log-rank p<0.0001). Patients with ED on conventional imaging that was downstaged to LD on PET had significantly longer OS than patients with ED on both conventional imaging and PET (median 328 days versus 177 days; log-rank p=0.037). CONCLUSIONS: The use of (18)FDG-PET during staging for SCLC had a major impact on stage classification, management and prognostic stratification. The use of staging PET should be considered in patients with newly diagnosed SCLC. No significant financial relationships to disclose.