Preoperative Risk Factors for Pathologic N2 Metastasis in Positron Emission Tomography-Computed Tomography–Diagnosed N0–1 Non-Small Cell Lung Cancer
10.5090/kjtcs.2019.52.4.221
- Author:
Tae hong YOON
1
;
Chul Ho LEE
;
Ki Sung PARK
;
Chi Hoon BAE
;
Jun Woo CHO
;
Jae Seok JANG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea. kspark69@cu.ac.kr
- Publication Type:Original Article
- Keywords:
Non-small-cell lung carcinoma;
Lymph nodes;
Neoplasm metastasis;
Positron emission tomography;
Computed tomography
- MeSH:
Carcinoma, Non-Small-Cell Lung;
Electrons;
Humans;
Incidence;
Lung Neoplasms;
Lymph Nodes;
Multivariate Analysis;
Neoplasm Metastasis;
Positron-Emission Tomography;
Prognosis;
Proportional Hazards Models;
Retrospective Studies;
Risk Factors;
Survival Rate;
Thorax
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2019;52(4):221-226
- CountryRepublic of Korea
- Language:English
-
Abstract:
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: 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: 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: 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.
