Results in mediastinal lymph node staging of surgical lung cancer: Data from the prospective cohort of the Spanish Video-Assisted Thoracic Surgery Group

Objectives: The objective of this study was to assess the diagnostic performance of combined computerised tomography (CT) and positron emission tomography (PET) in mediastinal staging of surgical lung cancer based on data obtained from the prospective cohort of the Spanish Group for Video-Assisted T...

Descripción completa

Detalles Bibliográficos
Autores: Lopez, I, Aguinagalde, B, Urreta, I, Royo, I, Bolufer, S, Sanchez, L, Zabaleta, J, Fernandez-Monge, A, Recuero, JL, Sesma, J, Amor, S, Moradiellos, FJ, Arraras, MJ, Blanco, AI, Boada, M, Sanchez, D, Cabanero, A, Moreno, N, Cal, I, Moreno, R, Cilleruelo, A, Crowley, S, Gomez, D, Fernandez, E, Hernando, F, Garcia, S, Lopez, C, Garcia, MD, Garcia, JM, Rivo, JE, Garcia, JA, Gelbenzu, JJ, Ramirez, ME, Giraldo, CF, Mongil, R, Gomez, MT, Jimenez, M, Henandez, J, Fibla, JJ, Illana, J, Jauregui, A, Jimenez, U, Rojo, R, Martinez, NJ, Martinez, E, Trujillo, JC, Milla, L, Moreno, SB, Congregado, M, Obiols, C, Call, S, Quero, F, Ramos, R, Rodriguez, A, Simon, CM, Embun, R
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p15477
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/15477
Access Level:acceso abierto
Palabra clave:Lung cancer
Lung resection
Mediastinal staging
Lymph node staging
Computerised tomography
Positron emission tomography
Descripción
Sumario:Objectives: The objective of this study was to assess the diagnostic performance of combined computerised tomography (CT) and positron emission tomography (PET) in mediastinal staging of surgical lung cancer based on data obtained from the prospective cohort of the Spanish Group for Video-Assisted Thoracic Surgery (GEVATS). Methods: A total of 2782 patients underwent surgery for primary lung carcinoma. We analysed diagnostic success in mediastinal lymph node staging (cN2) using CT and PET. Bivariate and multivariate analyses were performed of the factors involved in this success. The risk of unexpected pN2 disease was analysed for cases in which an invasive testing is recommended: cN1, the tumour centrally located or the tumour diameter >3 cm. Results: The overall success of CT together with PET was 82.9% with a positive predictive value of 0.21 and negative predictive value of 0.93. If the tumour was larger than 3 cm and for each unit increase in mediastinal SUVmax, the probability of success was lower with OR 0.59 (0.44-0.79) and 0.71 (0.66-0.75), respectively. In the video-assisted thoracic surgery (VATS) approach, the probability of success was higher with OR 2.04 (1.52-2.73). The risk of unexpected pN2 increased with the risk factors cN1, the tumour centrally located or the tumour diameter >3 cm: from 4.5% (0 factors) to 18.8% (3 factors) but did not differ significantly as a function of whether invasive testing was performed. Conclusions: CT and PET together have a high negative predictive value. The overall success of the staging is lower in the case of tumours >3 cm and high mediastinal SUVmax, and it is higher when VATS is performed. The risk of unexpected pN2 is higher if the disease is cN1, the tumour centrally located or the tumour diameter >3 cm but does not vary significantly as a function of whether patients have undergone invasive testing. (C) 2022 AEC. Published by Elsevier Espani a, S.L.U. All rights reserved.

Similares en LA Referencia