Lymph Node Size and Metastatic Infiltration in Non-small Cell Lung Cancer*

Prenzel, Klaus L.; Mönig, Stefan P.; Sinning, Jan Malte; Baldus, Stephan; Brochhagen, Hans-Georg; Schneider, Paul M.; Hölscher, Arnulf H.

doi:10.1378/chest.123.2.463

Cited by 150 publications

(83 citation statements)

References 18 publications

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“…In non-small cell lung cancers, Prenzel et al reported that the overall positive predictive value was 30.8%, using 80 preoperative CT scans in the diagnosis of the involvement of mediastinal lymph node metastasis. In this study, there was little correlation between metastasis and lymph node size (9). This group had previously demonstrated that in patients with gastric cancer, 55% of regional metastatic lymph nodes were less than 5 mm in diameter (10).…”

Section: Discussioncontrasting

confidence: 54%

CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer

et al. 2005

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ObjectivesThe extent of para-aortic lymph nodes (PANs) metastasis is equivalent to distant metastases in patients with biliary carcinoma. Accurate preoperative assessment of PANs metastasis has a crucial impact on surgical indication. In this retrospective study, we evaluated whether computed tomography (CT) scans were useful for diagnosing PANs metastases and excluding patients with PANs metastases from surgical indication. MethodsBetween March 1999 and November 2003, 57 patients with biliary carcinoma underwent radical lymphadenectomy or surgical biopsy of PANs, nine of whom was diagnosed as having positive PANs microscopically. All patients had undergone abdominal CT scans before surgery. To diagnose PANs metastases, we used the following diagnostic criteria. 1) Size: when lymph nodes were greater than 12 mm, 10 mm, 8 mm or 6mm in diameter in long or short axis diameter, the nodes were considered metastatic. 2) Shape and size: when the axial ratio of a lymph node was greater than 0.5, 0.7, 1.0, and the maximum diameter in the long or short axis was greater than 12 mm, 10 mm, 8 mm, or 6mm the node was considered metastatic. 3)Internal structure: if the internal structure of a PANs was heterogeneous, the node was 2 considered metastatic. The positive predictive value was calculated for each included criterion when patients numbered 10 or more. ResultsPositive predictive values using these criteria range from 13% to 36%. Only one patient had PANs with heterogeneous internal structures. ConclusionWe were unable to determine surgical indication based on the morphological criteria revealed by a CT scan.

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Section: Discussioncontrasting

confidence: 54%

CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer

et al. 2005

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“…In accordance with Prenzel and coworkers [18], we also found that the long-axis diameter of lymph nodes containing metastatic tumor is not significantly different from those free of tumor. Because lymph node size is not significantly different when involved by metastatic mesothelioma, preoperative imaging using size criteria will be unreliable for staging extrapleural lymph node metastasis, and this justifies the low results in patient selection achieved by positron emission tomography [19,20].…”

Section: Commentsupporting

confidence: 93%

The Value of Occult Disease in Resection Margin and Lymph Node After Extrapleural Pneumonectomy for Malignant Mesothelioma

Mineo

Ambrogi

Pompeo

et al. 2008

The Annals of Thoracic Surgery

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“…We found 11-14% of N2 disease in clinical stage I NSCLC, when lymph nodes less than 1cm in diameter by CT scan are regarded as node-negative. Several studies demonstrated that there are 12-17% of N2 positive patients who preoperatively diagnosed as N0 (4,14,15). And FDG-PET proved significantly more accurate than CT in demonstrating and staging of nodal involvement (12,13).…”

Section: Discussionmentioning

confidence: 99%

“…Accuracy of CT in preoperative mediastinal lymph node staging was 45 to 79% (11)(12)(13)(14)(15). Recently, cervical mediastinoscopy or positron emission tomography (PET) scanning with 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) proved more accurate than computed tomography (CT) in demonstration and staging of nodal involvement (11)(12)(13).…”

Section: Effect Of Mediastinal Lymph Nodes Sampling In Patients With mentioning

confidence: 99%

Effect of mediastinal lymph nodes sampling in patients with clinical stage I non-small cell lung cancer

et al. 2008

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:Objective : Systematic nodal dissection has been recommended for patients with resectable non-small cell lung cancer because of its staging accuracy. However, in patients with clinical stage I non-small cell lung cancer whether systematic nodal dissection provides more benefits than mediastinal lymph node sampling or not is controversial. In this retrospective study, we evaluated the effect of mediastinal lymph node sampling in patients with clinical stage I NSCLC. Methods : One hundred and nineteen consecutive patients with clinical stage I NSCLC, who underwent curative operation between January 1994 and December 2000, were retrospectively reviewed (dissection group = 58 : sampling group= 61). Systematic nodal dissection was defined as complete removal of mediastinal lymph node, and mediastinal lymph node sampling was defined as removal of lymph node levels 3, 4, and 7 for right-sided tumors and levels 5, 6, and 7 for left-sided tumors. Results : The total number of removed mediastinal lymph nodes in patients who underwent systematic nodal dissection was 22.1 9.7, which was significantly higher than that in patients who underwent mediastinal lymph node sampling of 11.4 7.0 (p 0.001). Postoperatively N2 disease was detected in 8 patients (13.8% %) in the dissection group and 7 (11.5% %) in the sampling group. After the median follow up of 79 months, the cancer specific survival rate at 5 year was 78.0% % in the dissection group and 76.2% % in the sampling group (p = 0.60). Conclusions : Mediastinal lymph node sampling showed the similar effect to systematic nodal dissection in patients with clinical stage I non-small cell lung cancer. J. Med. Invest. 55 : 37-43, February, 2008

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Lymph Node Size and Metastatic Infiltration in Non-small Cell Lung Cancer*

Cited by 150 publications

References 18 publications

CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer

CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer

The Value of Occult Disease in Resection Margin and Lymph Node After Extrapleural Pneumonectomy for Malignant Mesothelioma

Effect of mediastinal lymph nodes sampling in patients with clinical stage I non-small cell lung cancer

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