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World Journal of Surgery

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01-09-2018 | Original Scientific Report

Consolidation/Tumor Ratio on Chest Computed Tomography as Predictor of Postoperative Nodal Upstaging in Clinical T1N0 Lung Cancer

Authors: Youngkyu Moon, Jae Kil Park, Kyo Young Lee, Min Namkoong, Seha Ahn

Published in: World Journal of Surgery | Issue 9/2018

Abstract

Background

In clinical T1N0 peripheral lung cancers, lymph node upstaging is occasionally encountered postoperatively. However, nodal upstaging is rare in lung cancers presenting as ground-glass opacities. The aim of this study was to determine if lymph node upstaging could be reliably extrapolated from parameters such the consolidation/tumor ratio of chest computed tomography.

Methods

We conducted a retrospective study of 486 patients treated for peripheral clinical T1N0 non-small cell lung cancer, each undergoing lobectomy with mediastinal lymph node dissection. We compared preoperative variables in the pathologic N0 and nodal upstaging groups, analyzing such variables to determine factors predictive of lymph node upstaging.

Results

Of the 486 patients studied, lymph node upstaging occurred in 42 (8.6%). In the upstaging group, the mean nodule diameter exceeded that of the pathologic N0 group (2.3 vs 1.9 cm, respectively; p < 0.001), and the mean consolidation/tumor ratio was larger in the upstaging group than the pN0 group (0.95 vs 0.68, respectively; p < 0.001). Nodule diameter and consolidation/tumor ratio emerged as significant predictive factors for lymph node upstaging after surgery in a multivariate analysis (hazard ratio [HR] 2.259, p = 0.039; HR 173.645, p = 0.001, respectively).

Conclusions

Consolidation/tumor ratio and nodule diameter are significant predictive factors of postoperative lymph node upstaging. The higher the consolidation/tumor ratio and smaller the nodule diameter, the less likely the occurrence of postoperative lymph upstaging would be in clinical T1N0 peripheral non-small cell lung cancer.

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Title: Consolidation/Tumor Ratio on Chest Computed Tomography as Predictor of Postoperative Nodal Upstaging in Clinical T1N0 Lung Cancer
Authors: Youngkyu Moon
Jae Kil Park
Kyo Young Lee
Min Namkoong
Seha Ahn
Publication date: 01-09-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 9/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4543-8

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Consolidation/Tumor Ratio on Chest Computed Tomography as Predictor of Postoperative Nodal Upstaging in Clinical T1N0 Lung Cancer

Abstract

Background

Methods

Results

Conclusions

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Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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