In Ha Kim, Yooyoung Chong, Jae Kwang Yun, Sehoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Geun Dong Lee
{"title":"Analysis of lymph node metastasis based on consolidation tumor ratio and maximum standardized uptake value in clinical stage IA non-small cell lung cancer.","authors":"In Ha Kim, Yooyoung Chong, Jae Kwang Yun, Sehoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Geun Dong Lee","doi":"10.21037/jtd-24-1780","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sublobar resection has been established as an acceptable treatment for early-stage non-small cell lung cancer (NSCLC). As a result, preoperative prediction of lymph node (LN) metastasis is becoming an important factor in determining surgical strategy. This study aimed to investigate the predictive accuracy of the consolidation tumor ratio (CTR) and the maximum standardized uptake value (maxSUV) of the primary tumor for LN metastasis in patients with clinical stage IA NSCLC.</p><p><strong>Methods: </strong>We performed a retrospective analysis using data from 1,338 patients with clinical stage IA NSCLC who underwent surgery between 2011 and 2019. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to identify the optimal maxSUV and CTR for predicting LN metastasis. Multivariate logistic regression analysis was performed to identify independent predictors of LN metastasis. Survival analyses were performed using Cox proportional hazards models to identify prognostic factors for death and recurrence.</p><p><strong>Results: </strong>Among the 896 patients who underwent lobectomy with systematic LN dissection, 9.8% (88 patients) were found to have LN metastasis. The ROC curve for CTR revealed an AUC of 0.689 [95% confidence interval (CI): 0.646-0.732, P<0.001], while the ROC curve for maxSUV yielded an AUC of 0.748 (95% CI: 0.705-0.791, P<0.001) for predicting LN metastasis. In pure solid mass (CTR =1) with maxSUV exceeding 5.0, LN metastasis was observed in 13.8% of tumor 0-2 cm and 25.7% of tumor 2.1-3 cm. Multivariate analysis identified CTR >0.5 (HR =1.741, 95% CI: 1.122-2.701, P=0.01) and maxSUV >5.0 (HR =2.004, 95% CI: 1.421-2.825, P<0.001) as independent prognostic factors for disease-free survival.</p><p><strong>Conclusions: </strong>In clinical stage IA NSCLC, LN metastasis can be predicted using CTR and maxSUV of the primary mass. It is crucial not to underestimate the rate of LN metastasis when determining the surgical extent.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"944-958"},"PeriodicalIF":2.1000,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898382/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-24-1780","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/20 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Analysis of lymph node metastasis based on consolidation tumor ratio and maximum standardized uptake value in clinical stage IA non-small cell lung cancer.
Background: Sublobar resection has been established as an acceptable treatment for early-stage non-small cell lung cancer (NSCLC). As a result, preoperative prediction of lymph node (LN) metastasis is becoming an important factor in determining surgical strategy. This study aimed to investigate the predictive accuracy of the consolidation tumor ratio (CTR) and the maximum standardized uptake value (maxSUV) of the primary tumor for LN metastasis in patients with clinical stage IA NSCLC.
Methods: We performed a retrospective analysis using data from 1,338 patients with clinical stage IA NSCLC who underwent surgery between 2011 and 2019. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to identify the optimal maxSUV and CTR for predicting LN metastasis. Multivariate logistic regression analysis was performed to identify independent predictors of LN metastasis. Survival analyses were performed using Cox proportional hazards models to identify prognostic factors for death and recurrence.
Results: Among the 896 patients who underwent lobectomy with systematic LN dissection, 9.8% (88 patients) were found to have LN metastasis. The ROC curve for CTR revealed an AUC of 0.689 [95% confidence interval (CI): 0.646-0.732, P<0.001], while the ROC curve for maxSUV yielded an AUC of 0.748 (95% CI: 0.705-0.791, P<0.001) for predicting LN metastasis. In pure solid mass (CTR =1) with maxSUV exceeding 5.0, LN metastasis was observed in 13.8% of tumor 0-2 cm and 25.7% of tumor 2.1-3 cm. Multivariate analysis identified CTR >0.5 (HR =1.741, 95% CI: 1.122-2.701, P=0.01) and maxSUV >5.0 (HR =2.004, 95% CI: 1.421-2.825, P<0.001) as independent prognostic factors for disease-free survival.
Conclusions: In clinical stage IA NSCLC, LN metastasis can be predicted using CTR and maxSUV of the primary mass. It is crucial not to underestimate the rate of LN metastasis when determining the surgical extent.
期刊介绍：
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
