Risk factors for N2 metastasis in patients with non-small-cell lung cancer

Abstract

SUV(max) and tumor cell grade are independent risk factors for N(2) metastasis.

18F-FDG primary tumor uptake to improve N status prediction in cT1 non-metastatic non-small cell lung cancer: development and validation of a positron emission tomography model

“…The T_SUVmax threshold of 6.05 is not directly comparable to the one reported in other studies: we did not seek an optimal threshold but a threshold minimizing the number of occult lymph nodes. However, it is interesting to note that this threshold remains in the same range as those previously reported between 4 ( 13 ) and 7.5 ( 12 ). The study by Vansteenkiste et al ( 17 ), although not directly concerning occult LNI, reported a better 2-year survival when the primary tumor had SUV lesser than 7 and tumor size lower than 3 cm.…”

“…For unresectable tumors, it would allow better planning of radiotherapy and possible adjuvant treatments. Overall, some 18F-FDG PET/CT predictors of occult LNI have already been described: primary tumor localization as central and right superior lobe tumors are associated with a greater risk of occult N2 node (6); primary tumor size: the negative predictive value of 18F-FDG PET/CT was higher for tumors of less than 3 cm in diameter (9)(10)(11); primary tumor 18F-FDG uptake (11)(12)(13). The objective of this study is to build and validate a model to identify patients without LNI more accurately than the simple visual interpretation of 18F-FDG PET/CT.…”

Competence in endosonographic techniques

“…Whilst many evidences support the relationship between a high FDG uptake in the primary tumor and the risk of lymphatic or distant metastatic spread, 12,22 the risk of occult mediastinal metastasis in case of low SUV value is less convincing or even contradicted by recent works. 23 Several meta-analyses on eUS-FNa alone, eBUS-TB-Na alone, and combined eUS+eBUS reported a pooled sensitivity of 83% to 94% for mediastinal staging of lung cancer. [24][25][26][27][28][29][30] Only one randomized controlled trial 31 has been performed, comparing the two staging strategies proposed in the eSTS 2007 guidelines (either mediastinos-tions with the descriptor R or L added to denote laterality (r, right; L, left).…”