Preoperative PET-SUVmax and volume based PET parameters of the primary tumor fail to predict nodal upstaging in early-stage lung cancer.

Autor: Okumus Ö; Department of Thoracic Surgery, University Medicine Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany., Mardanzai K; Department of Thoracic Surgery, University Medicine Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany., Plönes T; Department of Thoracic Surgery, University Medicine Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany., Theegarten D; Department of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany., Darwiche K; Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany., Schuler M; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Division of Thoracic Oncology, University Medicine Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany., Nensa F; Department of Radiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany., Hautzel H; Department of Nuclear Medicine, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany., Hermann K; Department of Nuclear Medicine, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany., Stuschke M; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany; Department of Radiation Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany., Hegedus B; Department of Thoracic Surgery, University Medicine Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany., Aigner C; Department of Thoracic Surgery, University Medicine Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany. Electronic address: clemens.aigner@rlk.uk-essen.de.
Jazyk: angličtina
Zdroj: Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2023 Feb; Vol. 176, pp. 82-88. Date of Electronic Publication: 2022 Dec 29.
DOI: 10.1016/j.lungcan.2022.12.013
Abstrakt: Objectives: Accurate nodal staging is of utmost importance in patients with lung cancer. FDG-PET/CT imaging is now part of the routine staging. Despite thorough preoperative staging nodal upstaging still occurs in early-stage lung cancer. However, the predictive value of preoperative PET metrics of the primary tumor on nodal upstaging remains to be unexplored. Our aim was to assess the association of these preoperative PET-parameters with nodal upstaging in histologically confirmed lung adenocarcinoma and squamous cell carcinoma.
Methods: From January 2016 to November 2018, 500 patients with pT1-T2/cN0 lung cancer received an anatomical resection with curative intent. 171 patients with adenocarcinoma and squamous cell carcinoma and available PET-CTs were retrospectively included. We analyzed the the association of nodal upstaging with preoperative PET-SUVmax and metabolic PET metrics including total lesion glycolysis (TLG) and metabolic tumor volume (MTV) with different defined thresholds.
Results: High values of preoperative PET-SUVmax of the primary tumor were associated with squamous cell carcinoma (p < 0.0001) and with larger tumors (p < 0.0001). Increased preoperative C-reactive protein levels (<1mg/dL) correlated significantly with high preoperative PET-SUVmax values (p < 0.0001). No significant relationship between PET-SUVmax and lactate dehydrogenase activity (p = 0.6818), white blood cell count (p = 0.7681), gender (p = 0.1115) or age (p = 0.9284) was observed. Nodal upstaging rate was 14.0 % with 8.8 % N1 and 5.3 % N2 upstaging. Tumor size (p = 0.0468) and number of removed lymph nodes (p = 0.0461) were significant predictors of nodal upstaging but no significant association was found with histology or PET parameters. Of note, increased MTV - regardless of the threshold - tended to associate with nodal upstaging.
Conclusion: Early-stage lung cancer patients with squamous histology and T2 tumors presented increased preoperative PET-SUVmax values. Nevertheless, beyond tumor size and number of removed lymph nodes neither SUVmax nor metabolic PET parameters MTV and TLG were significant predictors of nodal upstaging.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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