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...

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Detalles Bibliográficos
Autores: Lopez I., Aguinagalde B., Urreta I., Royo I., Bolufer S., Sanchez L., Zabaleta J., Fernández-Monge A., Recuero J.L., Sesma J., Amor S., Moradiellos F.J., Arrarás M.J., Blanco A.I., Boada M., Sanchez D., Cabañero A., Moreno N., Cal I., Moreno R., Cilleruelo Á., Crowley S., Gómez D., Fernández E., Hernando F., García S., López C., García M.D., García J.M., Rivo J.E., Garcia J.A., Gelbenzu J.J., Ramírez M.E., Giraldo C.F., Mongil R., Gómez M.T., Jiménez M., Henández J., Fibla J.J., Illana J.D., Jauregui A., Jiménez U., Rojo R., Martínez N.J., Martínez E., Trujillo J.C., Milla L., Moreno S.B., Congregado M., Obiols C., Call S., Quero F., Ramos R., Rodríguez A., Simón C.M., Embun R.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p15897
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=15897
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85131431964&doi=10.1016%2fj.ciresp.2022.05.001&partnerID=40&md5=a9afd5a2744bb70e0357de1f7dc7313b
Access Level:acceso abierto
Palabra clave:Computerised tomography
Lung cancer
Lung resection
Lymph node staging
Mediastinal staging
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. © 2022 AEC

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