Risk Factors for Predicting Occult Lymph Node Metastasis in Patients with Clinical Stage I Non‐small Cell Lung Cancer Staged by Integrated Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Kaseda, Kaoru; Asakura, Keisuke; Kazama, Akio; Ozawa, Yukihiko

doi:10.1007/s00268-016-3652-5

Cited by 42 publications

(43 citation statements)

References 28 publications

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“…There are several techniques for lymph node dissection, including preoperative integrated fluorodeoxyglucose positron emission tomography/CT and freezing sections of lymph nodes during surgery; however, it is much more feasible and practical for surgeons to make a decision using preoperative clinicopathological characteristics.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of lymph node metastasis in patients with non‐small cell lung cancer ≤ 2 cm in size: A monocentric population‐based analysis

Shi

et al. 2017

Thoracic Cancer

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AimThis study was designed to determine the risk factors of lymph node metastasis in non‐small cell lung cancer (NSCLC) patients with tumors ≤ 2 cm, using the Shanghai Chest Hospital Lung Cancer Database.MethodsFive hundred and eighteen patients with NSCLC ≤ 2 cm were included in this study, and were classified into lymph node‐positive and lymph node‐negative groups. Univariate and multivariate logistic regression analyses were performed to select the independent risk factors for lymph node metastasis in NSCLC patients.ResultsNo evidence of metastasis was found in tumors ≤ 1 cm, all positive results were in tumors sized 1–2 cm. Imaging characteristics, including solid and part‐solid nodules, were strongly associated with lymph node metastasis (odds ratio [OR] 24.959, 95% confidence interval [CI] 5.999–103.835, P < 0.001; OR 12.559, 95% CI 3.564–44.259, P < 0.001) and subgroup logistic analysis (OR 21.384, 95% CI 5.058–90.407, P < 0.001; OR 11.632, 95% CI 3.290–41.126, P < 0.001). Greater lymph node metastasis was observed in non‐adeno non‐squamous carcinoma. The presence of pleural invasion and carcinoembryonic antigen levels indicated lymph node dissection. Similar results were revealed in subgroup analysis in tumors ≤ 2 to > 1 cm.ConclusionSize had a great impact on lymph node metastasis, especially tumors of 1–2 cm. Preoperative imaging, non‐adeno non‐squamous carcinoma, pleural invasion, and carcinoembryonic antigen all indicated lymph node dissection. There was no discrepancy between N1 and N2 positive lymph nodes.

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Section: Discussionmentioning

confidence: 99%

Risk factors of lymph node metastasis in patients with non‐small cell lung cancer ≤ 2 cm in size: A monocentric population‐based analysis

Shi

et al. 2017

Thoracic Cancer

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“…In non‐small cell lung cancer (NSCLC), quantitative measures of PET tracer uptake – (so called‐Maximum Standardised Uptake Value (SUV max )) has been shown to be able to predict occult nodal metastases from the metabolic activity of the primary tumour . In a multivariate analysis SUV max was independent of tumour size and importantly type of tumour, for predicting the presence of occult lymph node metastasis . In an initial study of 63 patients, an Optimal cut‐off value of 8.8 SUV max of the primary tumour was shown to predict occult metastases in NSCLC although in another larger cohort ( n = 163), an SUV max of 7 was deemed to be the best threshold for indicating metastatic risk; a value <7 was shown to be an independent prognostic factor for metastasis‐free survival .…”

Section: Metastatic Risk Assessmentmentioning

confidence: 99%

A risk‐based approach to identifying oligometastatic disease on imaging

deSouza

Tempany

2018

Intl Journal of Cancer

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Recognition of <3 metastases in <2 organs, particularly in cancers with a known predisposition to oligometastatic disease (OMD) (colorectal, prostate, renal, sarcoma and lung), offers the opportunity to focally treat the lesions identified and confers a survival advantage. The reliability with which OMD is identified depends on the sensitivity of the imaging technique used for detection and may be predicted from phenotypic and genetic factors of the primary tumour, which determine metastatic risk. Whole-body or organ-specific imaging to identify oligometastases requires optimization to achieve maximal sensitivity. Metastatic lesions at multiple locations may require a variety of imaging modalities for best visualisation because the optimal image contrast is determined by tumour biology. Newer imaging techniques used for this purpose require validation. Additionally, rationalisation of imaging strategies is needed, particularly with regard to timing of imaging and follow-up studies. This article reviews the current evidence for the use of imaging for recognising OMD and proposes a risk-based roadmap for identifying patients with true OMD, or at risk of metastatic disease likely to be OM.

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“…Then, studies with <100 patients were excluded to secure study quality. As shown in Table , seven reports have documented the usefulness of primary tumor SUVmax for the risk stratification of mediastinal ONM using a variety of cut‐off values . Li et al showed that tumor size and primary tumor SUVmax were independently associated with mediastinal ONM in patients with clinical stage I NSCLC .…”

Section: Introductionmentioning

confidence: 99%

“…Li et al showed that tumor size and primary tumor SUVmax were independently associated with mediastinal ONM in patients with clinical stage I NSCLC . More recently, Kaseda documented that classification of NSCLC specifically as ADC is one of the risk factors of ONM; this is in addition to primary tumor size and SUVmax . When examining ONM, some studies did not include FDG PET/CT parameters, but described other predictive risk factors, such as tumor size, ADC histology, and female sex .…”

Section: Introductionmentioning

confidence: 99%

“…When examining ONM, some studies did not include FDG PET/CT parameters, but described other predictive risk factors, such as tumor size, ADC histology, and female sex . All studies that included SUVmax showed a statistically significant stratification of ONM (Table ) . In contrast, there are no reports that evaluated risk factors for N1 ONM and N2 ONM separately.…”

Section: Introductionmentioning

confidence: 99%

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18F‐fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of clinically node‐negative non‐small cell lung cancer

Takahashi

Suzuki²,

Matsutani

et al. 2019

Thoracic Cancer

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One in four non‐small cell lung cancer (NSCLC) patients are diagnosed at an early‐stage. Following the results of the National Lung Screening Trial that demonstrated a survival benefit for low‐dose computed tomography screening in high‐risk patients, the incidence of early‐stage NSCLC is expected to increase. Use of 18F‐fluorodeoxyglucose positron emission tomography/computed tomography during initial diagnosis of these early‐stage lesions has been increasing. Traditionally, positron emission tomography/computed tomography scans have been utilized for mediastinal nodal staging and to rule out distant metastases in suspected early‐stage NSCLC. In clinically node‐negative NSCLC, the use of sublobar resection and selective lymph node dissection has been increasing as a therapeutic option. The higher rate of locoregional recurrences after limited resection and the significant incidence of occult lymph node metastases underscores the need to further stratify clinically node‐negative NSCLC in order to select patients for limited resection versus lobectomy with complete mediastinal lymph node dissection. In this report, we review the published data, and discuss the significance and potential role of 18F‐fluorodeoxyglucose positron emission tomography/computed tomography evaluation for clinically node‐negative NSCLC. Consequently, the literature review demonstrates that maximum standardized uptake value is a predictive factor for occult nodal metastasis with an accuracy of 55–77%. In addition, maximum standardized uptake value is a predictor for worse overall, as well as disease‐free, survival.

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Risk Factors for Predicting Occult Lymph Node Metastasis in Patients with Clinical Stage I Non‐small Cell Lung Cancer Staged by Integrated Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Cited by 42 publications

References 28 publications

Risk factors of lymph node metastasis in patients with non‐small cell lung cancer ≤ 2 cm in size: A monocentric population‐based analysis

Risk factors of lymph node metastasis in patients with non‐small cell lung cancer ≤ 2 cm in size: A monocentric population‐based analysis

A risk‐based approach to identifying oligometastatic disease on imaging

18F‐fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of clinically node‐negative non‐small cell lung cancer

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