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Different significance of HRCT and FDG-PET/CT to predict lymph node status between patients with clinical stage IA lung adenocarcinoma and squamous cell carcinoma
Journal of Cardiothoracic Surgery volume 10, Article number: A332 (2015)
True node-negative small sized non-small cell lung cancers are optimal candidates for sublobar resection without systematic lymph node dissection.
The purpose of this study is to identify the predictive factors of true node-negative clinical stage IA non-small cell lung cancer.
A multicenter database of patients with completely resected clinical stage IA lung adenocarcinoma (n = 502) or squamous cell carcinoma (n = 100) was retrospectively analyzed. The relationship between lymph node status and preoperative factors such as tumor size on HRCT and maximum standardized uptake value (SUVmax) on FDG-PET/CT were examined.
Multivariate analyses revealed that solid tumor size on HRCT (Odds ratio (OR), 1.42; p < 0.001) or SUVmax on FDG-PET/CT (OR, 1.04; p = 0.049) was identified as an independent predictor of lymph node metastasis in patients with lung adenocarcinoma. The predictive criteria of node-negative lung adenocarcinoma were solid tumor size <0.8 cm or SUVmax <1.5. Among patients who met the node-negative criteria, recurrence-free survival at 5 years was not significantly different between those who underwent lobectomy (96.0%) and those who underwent sublobar resection (97.2%). In patients with squamous cell carcinoma of the lung, no independent predictive factors for lymph node metastasis were identified in univariate or multivariate analysis.
Either solid tumor size on HRCT or SUVmax on FDG-PET/CT was a significant independent predictor of nodal status in clinical stage IA lung adenocarcinoma. The node-negative criteria of solid tumor size <0.8 cm or SUVmax <1.5 are helpful for choosing candidates for sublobar resection without systematic lymphadenectomy. In patients with clinical stage IA lung squamous cell carcinoma, systematic lymphadenectomy is advisable.
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Tsutani, Y., Miyata, Y., Mimura, T. et al. Different significance of HRCT and FDG-PET/CT to predict lymph node status between patients with clinical stage IA lung adenocarcinoma and squamous cell carcinoma. J Cardiothorac Surg 10, A332 (2015). https://doi.org/10.1186/1749-8090-10-S1-A332
- Squamous Cell Carcinoma
- Lung Adenocarcinoma
- Significant Independent Predictor
- Maximum Standardize Uptake
- Independent Predictive Factor