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S.J. Lee
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P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.03-012 - Prediction of Occult Lymph Node Metastasis Using Metabolic PET Parameters in Small Size Peripheral Non-Small Cell Lung Cancer (ID 1308)
09:30 - 09:30 | Author(s): S.J. Lee
- Abstract
Background:
Small size peripheral non-small cell lung cancer (NSCLC) patients without lymph node metastasis may be the optimal candidates for sublobar resection. We aimed to identify the predictors of occult lymph node metastasis using F-18 fluorodeoxyglucose positron emission positron emission tomography/computer tomography (PET/CT) in small size NSCLC patients who were clinically node negative.
Methods:
One hundred fifty three patients with small size NSCLC (less than 3cm in diameter) who underwent surgical resection with mediastinal lymph node dissection were evaluated. The maximum standardized uptake value (SUVmax), metabolic total volume (MTV), and total lesion glycolysis (TLG) of primary tumor were measured on pretreatment PET/CT. These metabolic parameters and pathological variables were analyzed for lymph node metastasis.
Results:
The mean tumor size was 2.11 ± 0.55 cm and the mean numbers of dissected lymph nodes were 16.33 ± 9.81. The adenocarcinoma was 103 (67.3%). Thirty patients (19.6%) had lymph node metastasis. The mean SUVmax, MTV and TLG were 4.85 ± 4.02 (0.5 ~ 16.4), 3.39 ± 5.54 (0 ~27.2) and 14.99 ± 27.78 (0 ~155.9), respectively. On receiver operating characteristic curve analysis, area under the curve (AUC) of SUVmax, MTV, TLG for node metastasis were 0.744, 0.750 and 0.745, respectively. On multivariate analysis, SUVmax (Odds ratio [OR] = 1.172, p=0.006), MTV (OR = 1.153, p=0.002) and TLG (OR=1.024, p=0.08) were risk factors for node metastasis after adjusting the tumor size and cell type. The concordance index of MTV was 0.722, which was slightly higher than those of SUVmax and TLG.Figure 1 Figure. ROC curve of each volume parameters of positron emission tomography/computer tomography for predicting the node metastasis
Conclusion:
SUVmax and volume-dependent parameters of primary lesion were significant risk factors for node metastasis in small peripheral NSCLC. MTV showed better predictive performance than other PET parameters, therefore MTV may be the possible indicator for sublobar resection in clinically node-negative small size NSCLC.
