Details

Autor(en) / Beteiligte

• Hino, Haruaki
• Utsumi, Takahiro
• Maru, Natsumi
• Matsui, Hiroshi
• Taniguchi, Yohei
• Saito, Tomohito
• Murakawa, Tomohiro

Titel

Clinical impact and utility of positron emission tomography on occult lymph node metastasis and survival: radical surgery for stage I lung cancer

Ist Teil von

• General thoracic and cardiovascular surgery, 2021-08, Vol.69 (8), p.1196-1203

Ort / Verlag

Singapore: Springer Singapore

Erscheinungsjahr

2021

Link zum Volltext

Quelle

SpringerLink

Beschreibungen/Notizen

• Objective The surgical result of early-staged lung cancer is not satisfactory due to unexpected postoperative lymph node metastasis and recurrence. This study aimed to investigate which preoperative factors—including the standard uptake value max (SUV max ) of positron emission tomography—could predict occult lymph node metastasis and survival. Methods We retrospectively analyzed data from 598 patients with clinical stage I lung cancer who underwent surgery, and examined their preoperative clinical characteristics. Results A total of 1586 patients had surgery for primary lung cancer between 2006 and 2019; 598 patients with clinical stage I lung cancer were the study inclusion; occult lymph node metastasis was detected in 102 (17.1%). Univariable and multivariable analyses showed that SUV max  ≥ 3 ( P  < 0.001), clinical invasive tumor size ≥ 2 cm ( P  = 0.009), and carcinoembryonic antigen > 5 ( P  = 0.03) were associated with significant risk factors rated (%) for occult lymph node metastasis, as follows: high-risk group (three factors), moderate-risk group (two factors) and low-risk group (one factor or none) corresponding to 32.2 (28/87), 22.8 (41/180) and 7.3 (19/262), respectively ( P  < 0.001). The 5-year overall survival rates (%) of patients without lymph node metastasis holding SUV max 6 or over were as poor as those of patients with lymph node metastasis (72.0% vs 64.1%; P  = 0.56). Conclusions We might consider wedge resection or segmentectomy, omitting lymphadenectomy, for the low-risk group; adjuvant therapy is indicated for patients without lymph node metastasis having SUV max 6 or over.