Risk factors for predicting the occult nodal metastasis in T1–2N0M0 NSCLC patients staged by PET/CT: Potential value in the clinic

Li, Ling; Ren, Shuhua; Zhang, Yingjian; Guan, Yihui; Zhao, Jun; Li, Jun; Wang, Qun; Chen, Gang; Chen, Haiquan; Xiang, Jiaqing; Fu, Xiaolong

doi:10.1016/j.lungcan.2013.04.012

Cited by 59 publications

(63 citation statements)

References 19 publications

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“…Previous studies have demonstrated an association of SUVmax with occult nodal disease in lung cancer . Our findings add the following to the literature: (a) further validation of associations of SUVmax with N descriptors and stage groupings in the 8th edition of TNM classification; (b) the significance and heterogeneity of primary tumor SUVmax in different histopathological subtypes of lung adenocarcinoma, such as LEP, ACI, PAP, SOL, and MIP; (c) discriminative cutoff point for nodal disease at SUVmax of 3.8 using ROC analyses; (d) the only independent pre‐operative predictive value of SUVmax for pathological nodal metastasis; (e) independent prognostic value of SUVmax for patient survival; and (f) clinical significance of SUVmax in high selected patients with large sample volume (670 cases with peripheral cN0 NSCLC with tumor size ≤2 cm).…”

Section: Discussionsupporting

confidence: 71%

Clinical significance of PET/CT uptake for peripheral clinical N0 non‐small cell lung cancer

et al. 2020

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Objective In this cohort study, we determined the clinical value of the maximum standardized uptake value (SUVmax) of primary tumors in non‐small cell lung cancer (NSCLC). Study Design A retrospective review of NSCLC patients was performed from January 2011 to December 2017. Peripheral cN0 NSCLC patients with tumor size ≤2 cm were included. SUVmax was calculated as a continuous variable for semiquantitative analyses. A receiver operating characteristic curve was analyzed to assess the cutoff threshold of SUVmax on pathological (p) nodal metastasis. We further evaluated the clinical relevance of SUVmax in peripheral cN0 NSCLC patients. Results A total of 670 peripheral NSCLC patients with tumor size ≤2 cm were deemed cN0 by preoperative PET/CT scan. Statistical analyses suggested significant correlations of SUVmax with smoking status (P = .026), tumor volume (P = .001), pathology type (P = .008), tumor differentiation (P < .001), vessel invasion (P = .001), plural invasion (P < .001), pT stage (P < .001), nodal involvement (P < .001), and pathological tumor node metastasis stage (P < .001). A cutoff point of SUVmax of 3.8 (P < .001) could be used to predict pathological nodal metastasis. Multivariable analyses indicated that preoperative SUVmax >3.8 (odds ratio, 12.149; P < .001) was an independent predictor of nodal metastasis. Overall survival analyses further suggested that SUVmax was an independent prognostic indicator (hazard ratio, 2.050; P = .017). Conclusion Preoperative SUVmax is a predictor of pathological nodal metastasis and prognosis for peripheral cN0 NSCLC patients with tumor size ≤2 cm. Our results indicate that assessment of PET SUVmax could improve stratification of these patients.

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Section: Discussionsupporting

confidence: 71%

Clinical significance of PET/CT uptake for peripheral clinical N0 non‐small cell lung cancer

et al. 2020

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“…A lymph node where the SUV max was ≥1.5 was considered 'suspected malignancy.' However, even lymph nodes with high FDG uptake were also considered benign when they had higher attenuation than mediastinal structures (great vessels) or benign central, nodular, diffuse or popcorn-like calcification (18).…”

Section: Fdg-pet/ct Imagingmentioning

confidence: 99%

Radiologic findings to predict low-grade malignant tumour among clinical T1bN0 lung adenocarcinomas: lessons from histological subtypes

Mimae

Miyata

Mimura

et al. 2015

Jpn. J. Clin. Oncol.

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Objective: Some clinical T1bN0 (cT1bN0) lung adenocarcinomas (2-3 cm) are thought to have lessaggressive and less-malignant behaviour although most cT1aN0 tumours (≤2 cm) are indolent. The present study aimed to identify pre-operative radiographic findings that can predict cT1bN0 lung adenocarcinoma with low-malignant aggressiveness in consideration of histological subtypes. Methods: The clinicopathological features and prognoses of 224 consecutive patients (histological subtype set, n = 122; prognosis set, n = 224) with cT1bN0 lung adenocarcinoma were retrospectively examined. Adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic, node-negative papillary and node-negative acinar predominant invasive adenocarcinomas were defined as lowgrade malignant, whereas solid, micropapillary, node-positive acinar and node-positive papillary predominant invasive adenocarcinoma were defined as high-grade malignant. Results: Receiver operating characteristics analysis revealed that the criteria of solid tumour size ≤1.8 cm on high-resolution computed tomography and the maximum standardized uptake value ≤3.2 on positron emission tomography/computed tomography could predict low-grade malignant tumour in the histological subtype set. Among 95 (42.4%) of 224 patients who met the criteria for the prognosis set, 94 (98.9%) had no lymph node metastasis and 93 (97.9%) had no recurrence (median follow-up, 43.6 months). The 3 year recurrence-free survival rates were 94.9 and 79.0% in patients whose pre-operative findings met and did not meet the criteria, respectively. Conclusions: Pre-operative radiographic findings of solid tumour size and the maximum standardized uptake value could identify low-grade malignant tumour among cT1bN0 lung adenocarcinomas, which account for about half of all cT1bN0 tumours. Patients with pre-operative lung tumour findings that fulfill the criteria could be candidates for sublobar resection.

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“…This is known as the Warburg effect and is considered the seventh hallmark of cancer [1]. This effect has been exploited in 18F-fluorodeoxyglucose positron emission tomography/computerized tomography ( 18 F-FDG PET/CT) technologies, which has proved highly successful in clinical practice and is widely applied in tumor diagnosis [2], [3].…”

Section: Introductionmentioning

confidence: 99%

TIGAR Is Correlated with Maximal Standardized Uptake Value on FDG-PET and Survival in Non-Small Cell Lung Cancer

Zhou

Xie

et al. 2013

PLoS ONE

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ObjectiveEvaluation of 18F-FDG uptake value via PET is central to current methods of diagnosis and staging of non-small cell lung cancer (NSCLC) due to its ability to evaluate expression levels of key regulators associated with glucose metabolism in tumor cells. Tp53-induced glycolysis and apoptosis regulator (TIGAR) is an important P53-induced protein that can inhibit glycolysis; however, there have been few clinical studies on its mechanism. Here we have investigated the relationship between TIGAR expression and 18F-FDG PET in tumors, along with its relationship with the clinical characteristics of NSCLC.MethodsWe analyzed SUVmax in 79 patients with NSCLC through immunohistochemical staining of TIGAR and five other biological markers associated with tumor cell glycolysis, in order to evaluate the correlation between their expression and SUVmax. We also plotted Kaplan-Meier survival curves to assess TIGAR expression with the prognosis and survival of patients with NSCLC.ResultsThe key findings were as follows: SUVmax was negatively correlated with the expression of TIGAR (r = −0.31, p<0.01); TIGAR expression was correlated with tumor size (p = 0.01), histological type (p<0.01), differentiation degree (p<0.01) and lymph node metastasis(p<0.01) in patients with NSCLC; and the survival time of patients whose TIGAR was negatively expressed was significantly shorter than for those whose TIGAR was positively expressed (P = 0.023).ConclusionsThe expression of TIGAR in primary tumors is significantly correlated with SUVmax, and low expression of TIGAR may predict a worse clinical outcome in patients with NSCLC.

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Risk factors for predicting the occult nodal metastasis in T1–2N0M0 NSCLC patients staged by PET/CT: Potential value in the clinic

Cited by 59 publications

References 19 publications

Clinical significance of PET/CT uptake for peripheral clinical N0 non‐small cell lung cancer

Clinical significance of PET/CT uptake for peripheral clinical N0 non‐small cell lung cancer

Radiologic findings to predict low-grade malignant tumour among clinical T1bN0 lung adenocarcinomas: lessons from histological subtypes

TIGAR Is Correlated with Maximal Standardized Uptake Value on FDG-PET and Survival in Non-Small Cell Lung Cancer

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