Preoperative Risk Factors for Pathologic N2 Metastasis in Positron Emission Tomography-Computed Tomography-Diagnosed N0-1 Non-Small Cell Lung Cancer.
Computed tomography
Lymph nodes
Neoplasm metastasis
Non-small-cell lung carcinoma
Positron emission tomography
Journal
The Korean journal of thoracic and cardiovascular surgery
ISSN: 2233-601X
Titre abrégé: Korean J Thorac Cardiovasc Surg
Pays: Korea (South)
ID NLM: 101563922
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
16
08
2018
revised:
05
12
2018
accepted:
06
12
2018
entrez:
13
8
2019
pubmed:
14
8
2019
medline:
14
8
2019
Statut:
ppublish
Résumé
Accurate mediastinal lymph node staging is vital for the optimal therapy and prognostication of patients with lung cancer. This study aimed to determine the preoperative risk factors for pN2 disease, as well as its incidence and long-term outcomes, in patients with clinical N0-1 non-small cell lung cancer. We retrospectively analyzed patients who were treated surgically for primary non-small cell lung cancer from November 2005 to December 2014. Patients staged as clinical N0-1 via chest computed tomography (CT) and positron emission tomography (PET)-CT were divided into two groups (pN0-1 and pN2) and compared. In a univariate analysis, the significant preoperative risk factors for pN2 included a large tumor size (p=0.083), high maximum standard uptake value on PET (p<0.001), and central location of the tumor (p<0.001). In a multivariate analysis, central location of the tumor (p<0.001) remained a significant preoperative risk factor for pN2 status. The 5-year overall survival rates were 75% and 22.9% in the pN0-1 and pN2 groups, respectively, and 50% and 78.2% in the patients with centrally located and peripherally located tumors, respectively. In a Cox proportional hazard model, central location of the tumor increased the risk of death by 3.4-fold (p<0.001). More invasive procedures should be considered when pre-operative risk factors are identified in order to improve the efficacy of diagnostic and therapeutic plans and, consequently, the patient's prognosis.
Sections du résumé
BACKGROUND
BACKGROUND
Accurate mediastinal lymph node staging is vital for the optimal therapy and prognostication of patients with lung cancer. This study aimed to determine the preoperative risk factors for pN2 disease, as well as its incidence and long-term outcomes, in patients with clinical N0-1 non-small cell lung cancer.
METHODS
METHODS
We retrospectively analyzed patients who were treated surgically for primary non-small cell lung cancer from November 2005 to December 2014. Patients staged as clinical N0-1 via chest computed tomography (CT) and positron emission tomography (PET)-CT were divided into two groups (pN0-1 and pN2) and compared.
RESULTS
RESULTS
In a univariate analysis, the significant preoperative risk factors for pN2 included a large tumor size (p=0.083), high maximum standard uptake value on PET (p<0.001), and central location of the tumor (p<0.001). In a multivariate analysis, central location of the tumor (p<0.001) remained a significant preoperative risk factor for pN2 status. The 5-year overall survival rates were 75% and 22.9% in the pN0-1 and pN2 groups, respectively, and 50% and 78.2% in the patients with centrally located and peripherally located tumors, respectively. In a Cox proportional hazard model, central location of the tumor increased the risk of death by 3.4-fold (p<0.001).
CONCLUSION
CONCLUSIONS
More invasive procedures should be considered when pre-operative risk factors are identified in order to improve the efficacy of diagnostic and therapeutic plans and, consequently, the patient's prognosis.
Identifiants
pubmed: 31404414
doi: 10.5090/kjtcs.2019.52.4.221
pii: kjtcvs-52-221
pmc: PMC6687044
doi:
Types de publication
Journal Article
Langues
eng
Pagination
221-226Déclaration de conflit d'intérêts
Conflict of interest No potential conflict of interest relevant to this article was reported.
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