Skip to main content
Erschienen in: Surgery Today 10/2012

01.10.2012 | Original Article

Prediction of true-negative lymph node metastasis in clinical IA non-small cell lung cancer by measuring standardized uptake values on positron emission tomography

verfasst von: Tomoyoshi Takenaka, Tokujiro Yano, Yosuke Morodomi, Kensaku Ito, Naoko Miura, Daigo Kawano, Fumihiro Shoji, Shingo Baba, Koichiro Abe, Hiroshi Honda, Yoshihiko Maehara

Erschienen in: Surgery Today | Ausgabe 10/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We developed a method for predicting true-negative lymph node metastases in clinical IA non-small lung cancer (NSCLC) by the combined evaluation of computed tomography (CT), 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) findings and the maximum standardized uptake value (SUVmax) of primary tumors.

Methods

The subjects of this study were 94 patients with clinical stage IA NSCLC who underwent both preoperative CT and FDG-PET. We analyzed the relationship between the SUVmax of primary tumors and various clinicopathological factors to find the best method available for assessing true-negative lymph node metastasis.

Results

The pathological stages were IA (n = 80), IB (n = 4), IIA (n = 5), IIIA (n = 4), and IV (n = 1). Pathologic lymph node metastasis was recognized in nine patients and the SUVmax of these tumors ranged from 3.3 to 20.3. A SUVmax of 3.0 was defined as the cut-off point and patients were dichotomized according to this point. Tumors with SUVmax of 3.0 or less were associated with a significantly lower incidence of pleural and vascular invasion and were characterized by the degree of differentiation.

Conclusion

The SUVmax of primary tumors reflects the grade of malignancy; therefore, the combined evaluation of FDG-PET/CT findings with the SUVmax of primary tumors may help predict lymph node metastasis negativity.
Literatur
1.
Zurück zum Zitat Ramsey HE, Cahan WG, Beattie EJ, Humphrey C. The importance of radical lobectomy in lung cancer. J Thorac Cardiovasc Surg. 1969;58:225–30.PubMed Ramsey HE, Cahan WG, Beattie EJ, Humphrey C. The importance of radical lobectomy in lung cancer. J Thorac Cardiovasc Surg. 1969;58:225–30.PubMed
2.
Zurück zum Zitat Landreneau RJ, Sugarbaker DJ, Mack MJ, Hazelrigg SR, Luketich JD, Fetterman L, et al. Wedge resection versus lobectomy for stage I (T1 N0 M0) non-small-cell lung cancer. J Thorac Cardiovasc Surg. 1997;113:691–8.CrossRefPubMed Landreneau RJ, Sugarbaker DJ, Mack MJ, Hazelrigg SR, Luketich JD, Fetterman L, et al. Wedge resection versus lobectomy for stage I (T1 N0 M0) non-small-cell lung cancer. J Thorac Cardiovasc Surg. 1997;113:691–8.CrossRefPubMed
3.
Zurück zum Zitat Asamura H, Nakayama H, Kondo H, Tsuchiya R, Shimosato Y, Naruke T. Lymph node involvement, recurrence, and prognosis in resected small, peripheral, non-small-cell lung carcinomas: are these carcinomas candidates for video-assisted lobectomy? J Thorac Cardiovasc Surg. 1996;111:1125–34.CrossRefPubMed Asamura H, Nakayama H, Kondo H, Tsuchiya R, Shimosato Y, Naruke T. Lymph node involvement, recurrence, and prognosis in resected small, peripheral, non-small-cell lung carcinomas: are these carcinomas candidates for video-assisted lobectomy? J Thorac Cardiovasc Surg. 1996;111:1125–34.CrossRefPubMed
4.
Zurück zum Zitat Suzuki K, Nagai K, Yoshida J, Nishimura M, Nishiwaki Y. Predictors of lymph node and intrapulmonary metastasis in clinical stage IA non-small cell lung carcinoma. Ann Thorac Surg. 2001;72:352–6.CrossRefPubMed Suzuki K, Nagai K, Yoshida J, Nishimura M, Nishiwaki Y. Predictors of lymph node and intrapulmonary metastasis in clinical stage IA non-small cell lung carcinoma. Ann Thorac Surg. 2001;72:352–6.CrossRefPubMed
5.
Zurück zum Zitat Ung YC, Maziak DE, Vanderveen JA, Smith CA, Gulenchyn K, Lacchetti C, Lung Cancer Disease Site Group of Cancer Care Ontario’s Program in, et al. 18Fluorodeoxyglucose positron emission tomography in the diagnosis and staging of lung cancer: a systematic review. J Natl Cancer Inst. 2007;99:1741–3.CrossRef Ung YC, Maziak DE, Vanderveen JA, Smith CA, Gulenchyn K, Lacchetti C, Lung Cancer Disease Site Group of Cancer Care Ontario’s Program in, et al. 18Fluorodeoxyglucose positron emission tomography in the diagnosis and staging of lung cancer: a systematic review. J Natl Cancer Inst. 2007;99:1741–3.CrossRef
6.
Zurück zum Zitat Bryant AS, Cerfolio RJ. The maximum standardized uptake values on integrated FDG-PET/CT is useful in differentiating benign from malignant pulmonary nodules. Ann Thorac Surg. 2006;82:1016–20.CrossRefPubMed Bryant AS, Cerfolio RJ. The maximum standardized uptake values on integrated FDG-PET/CT is useful in differentiating benign from malignant pulmonary nodules. Ann Thorac Surg. 2006;82:1016–20.CrossRefPubMed
7.
Zurück zum Zitat Som P, Atkins HL, Bandoypadhyay D, Fowler JS, MacGregor RR, Matsui K, et al. A fluorinated glucose analog, 2-fluoro-2-deoxy-d-glucose (F-18): nontoxic tracer for rapid tumor detection. J Nucl Med. 1980;21:670–5.PubMed Som P, Atkins HL, Bandoypadhyay D, Fowler JS, MacGregor RR, Matsui K, et al. A fluorinated glucose analog, 2-fluoro-2-deoxy-d-glucose (F-18): nontoxic tracer for rapid tumor detection. J Nucl Med. 1980;21:670–5.PubMed
8.
Zurück zum Zitat Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, et al. Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med. 2003;348:2500–7.CrossRefPubMed Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, et al. Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med. 2003;348:2500–7.CrossRefPubMed
9.
Zurück zum Zitat Reed CE, Harpole DH, Posther KE, Woolson SL, Downey RJ, Meyers BF, American College of Surgeons Oncology Group Z0050 trial, et al. Results of the American College of Surgeons Oncology Group Z0050 trial: the utility of positron emission tomography in staging potentially operable non-small cell lung cancer. J Thorac Cardiovasc Surg. 2003;126:1943–51.CrossRefPubMed Reed CE, Harpole DH, Posther KE, Woolson SL, Downey RJ, Meyers BF, American College of Surgeons Oncology Group Z0050 trial, et al. Results of the American College of Surgeons Oncology Group Z0050 trial: the utility of positron emission tomography in staging potentially operable non-small cell lung cancer. J Thorac Cardiovasc Surg. 2003;126:1943–51.CrossRefPubMed
10.
Zurück zum Zitat World Health Organization. Histological typing of lung and pleural tumors. 3rd ed. Springer: Geneva; 1999. World Health Organization. Histological typing of lung and pleural tumors. 3rd ed. Springer: Geneva; 1999.
11.
Zurück zum Zitat Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, International Association for the Study of Lung Cancer International Staging Committee; Participating Institutions, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol. 2007;2:706–14.CrossRefPubMed Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, International Association for the Study of Lung Cancer International Staging Committee; Participating Institutions, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol. 2007;2:706–14.CrossRefPubMed
12.
Zurück zum Zitat Read RC, Yoder G, Schaeffer RC. Survival after conservative resection for T1 N0 M0 non-small cell lung cancer. Ann Thorac Surg. 1990;49:391–8.CrossRefPubMed Read RC, Yoder G, Schaeffer RC. Survival after conservative resection for T1 N0 M0 non-small cell lung cancer. Ann Thorac Surg. 1990;49:391–8.CrossRefPubMed
13.
Zurück zum Zitat Yoshikawa K, Tsubota N, Kodama K, Ayabe H, Taki T, Mori T. Prospective study of extended segmentectomy for small lung tumors: the final report. Ann Thorac Surg. 2002;73:1055–8.CrossRefPubMed Yoshikawa K, Tsubota N, Kodama K, Ayabe H, Taki T, Mori T. Prospective study of extended segmentectomy for small lung tumors: the final report. Ann Thorac Surg. 2002;73:1055–8.CrossRefPubMed
14.
Zurück zum Zitat Koike T, Yamato Y, Yoshiya K, Shimoyama T, Suzuki R. Intentional limited pulmonary resection for peripheral T1 N0 M0 small-sized lung cancer. J Thorac Cardiovasc Surg. 2003;125:924–8.CrossRefPubMed Koike T, Yamato Y, Yoshiya K, Shimoyama T, Suzuki R. Intentional limited pulmonary resection for peripheral T1 N0 M0 small-sized lung cancer. J Thorac Cardiovasc Surg. 2003;125:924–8.CrossRefPubMed
15.
Zurück zum Zitat Lee PC, Port JL, Korst RJ, Liss Y, Meherally DN, Altorki NK. Risk factors for occult mediastinal metastases in clinical stage I non-small cell lung cancer. Ann Thorac Surg. 2007;84:177–81.CrossRefPubMed Lee PC, Port JL, Korst RJ, Liss Y, Meherally DN, Altorki NK. Risk factors for occult mediastinal metastases in clinical stage I non-small cell lung cancer. Ann Thorac Surg. 2007;84:177–81.CrossRefPubMed
16.
Zurück zum Zitat Stiles BM, Servais EL, Lee PC, Port JL, Paul S, Altorki NK. Point: clinical stage IA non-small cell lung cancer determined by computed tomography and positron emission tomography is frequently not pathologic IA non-small cell lung cancer: the problem of understaging. J Thorac Cardiovasc Surg. 2009;137:13–9.CrossRefPubMed Stiles BM, Servais EL, Lee PC, Port JL, Paul S, Altorki NK. Point: clinical stage IA non-small cell lung cancer determined by computed tomography and positron emission tomography is frequently not pathologic IA non-small cell lung cancer: the problem of understaging. J Thorac Cardiovasc Surg. 2009;137:13–9.CrossRefPubMed
17.
Zurück zum Zitat Noguchi M, Morikawa A, Kawasaki M, Matsuno Y, Yamada T, Hirohashi S, et al. Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer. 1995;75:2844–52.CrossRefPubMed Noguchi M, Morikawa A, Kawasaki M, Matsuno Y, Yamada T, Hirohashi S, et al. Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer. 1995;75:2844–52.CrossRefPubMed
18.
Zurück zum Zitat Sagawa M, Higashi K, Sugita M, Ueda Y, Maeda S, Toga H, et al. Fluorodeoxyglucose uptake correlates with the growth pattern of small peripheral pulmonary adenocarcinoma. Surg Today. 2006;36:230–4.CrossRefPubMed Sagawa M, Higashi K, Sugita M, Ueda Y, Maeda S, Toga H, et al. Fluorodeoxyglucose uptake correlates with the growth pattern of small peripheral pulmonary adenocarcinoma. Surg Today. 2006;36:230–4.CrossRefPubMed
19.
Zurück zum Zitat Suzuki K, Kusumoto M, Watanabe S, Tsuchiya R, Asamura H. Radiologic classification of small adenocarcinoma of the lung: radiologic–pathologic correlation and its prognostic impact. Ann Thorac Surg. 2006;81:419–20.CrossRef Suzuki K, Kusumoto M, Watanabe S, Tsuchiya R, Asamura H. Radiologic classification of small adenocarcinoma of the lung: radiologic–pathologic correlation and its prognostic impact. Ann Thorac Surg. 2006;81:419–20.CrossRef
20.
Zurück zum Zitat Yoshino I, Ichinose Y, Nagashima A, Takeo S, Motohiro A, Yano T, Kyushu Lung Cancer Surgery Cooperative Group, et al. Clinical characterization of node-negative lung adenocarcinoma: results of a prospective investigation. J Thorac Oncol. 2006;1:825–31.CrossRefPubMed Yoshino I, Ichinose Y, Nagashima A, Takeo S, Motohiro A, Yano T, Kyushu Lung Cancer Surgery Cooperative Group, et al. Clinical characterization of node-negative lung adenocarcinoma: results of a prospective investigation. J Thorac Oncol. 2006;1:825–31.CrossRefPubMed
21.
Zurück zum Zitat De Leyn P, Lardinois D, Van Schil P, Rami-Porta R, Passlick B, Zielinski M, ESTS, et al. European trends in preoperative and intraoperative nodal staging: ESTS guidelines. J Thorac Oncol. 2007;2:357–61.CrossRefPubMed De Leyn P, Lardinois D, Van Schil P, Rami-Porta R, Passlick B, Zielinski M, ESTS, et al. European trends in preoperative and intraoperative nodal staging: ESTS guidelines. J Thorac Oncol. 2007;2:357–61.CrossRefPubMed
22.
Zurück zum Zitat Meyers BF, Haddad F, Siegel BA, Zoole JB, Battafarano RJ, Veeramachaneni N, et al. Cost-effectiveness of routine mediastinoscopy in computed tomography- and positron emission tomography-screened patients with stage I lung cancer. J Thorac Cardiovasc Surg. 2006;131:822–9.CrossRefPubMed Meyers BF, Haddad F, Siegel BA, Zoole JB, Battafarano RJ, Veeramachaneni N, et al. Cost-effectiveness of routine mediastinoscopy in computed tomography- and positron emission tomography-screened patients with stage I lung cancer. J Thorac Cardiovasc Surg. 2006;131:822–9.CrossRefPubMed
23.
Zurück zum Zitat Herth FJ, Eberhardt R, Vilmann P, Krasnik M, Ernst A. Real-time endobronchial ultrasound guided transbronchial needle aspiration for sampling mediastinal lymph nodes. Thorax. 2006;61:795–8.CrossRefPubMedPubMedCentral Herth FJ, Eberhardt R, Vilmann P, Krasnik M, Ernst A. Real-time endobronchial ultrasound guided transbronchial needle aspiration for sampling mediastinal lymph nodes. Thorax. 2006;61:795–8.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Szlubowski A, Kuzdzał J, Kołodziej M, Soja J, Pankowski J, Obrochta A, et al. Endobronchial ultrasound-guided needle aspiration in the non-small cell lung cancer staging. Eur J Cardiothorac Surg. 2009;35:332–5.CrossRefPubMed Szlubowski A, Kuzdzał J, Kołodziej M, Soja J, Pankowski J, Obrochta A, et al. Endobronchial ultrasound-guided needle aspiration in the non-small cell lung cancer staging. Eur J Cardiothorac Surg. 2009;35:332–5.CrossRefPubMed
25.
Zurück zum Zitat Okada M, Nakayama H, Okumura S, Daisaki H, Adachi S, Yoshimura M, Miyata Y. Multicenter analysis of high-resolution computed tomography and positron emission tomography/computed tomography findings to choose therapeutic strategies for clinical stage IA lung adenocarcinoma. J Thorac Cardiovasc Surg. 2011;141:1384–91.CrossRefPubMed Okada M, Nakayama H, Okumura S, Daisaki H, Adachi S, Yoshimura M, Miyata Y. Multicenter analysis of high-resolution computed tomography and positron emission tomography/computed tomography findings to choose therapeutic strategies for clinical stage IA lung adenocarcinoma. J Thorac Cardiovasc Surg. 2011;141:1384–91.CrossRefPubMed
Metadaten
Titel
Prediction of true-negative lymph node metastasis in clinical IA non-small cell lung cancer by measuring standardized uptake values on positron emission tomography
verfasst von
Tomoyoshi Takenaka
Tokujiro Yano
Yosuke Morodomi
Kensaku Ito
Naoko Miura
Daigo Kawano
Fumihiro Shoji
Shingo Baba
Koichiro Abe
Hiroshi Honda
Yoshihiko Maehara
Publikationsdatum
01.10.2012
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 10/2012
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-012-0277-7

Weitere Artikel der Ausgabe 10/2012

Surgery Today 10/2012 Zur Ausgabe

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Metformin rückt in den Hintergrund

24.04.2024 DGIM 2024 Kongressbericht

Es hat sich über Jahrzehnte klinisch bewährt. Doch wo harte Endpunkte zählen, ist Metformin als alleinige Erstlinientherapie nicht mehr zeitgemäß.

Myokarditis nach Infekt – Richtig schwierig wird es bei Profisportlern

24.04.2024 DGIM 2024 Kongressbericht

Unerkannte Herzmuskelentzündungen infolge einer Virusinfektion führen immer wieder dazu, dass junge, gesunde Menschen plötzlich beim Sport einen Herzstillstand bekommen. Gerade milde Herzbeteiligungen sind oft schwer zu diagnostizieren – speziell bei Leistungssportlern. 

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.