International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification predicts occult lymph node metastasis in clinically mediastinal node-negative lung adenocarcinoma Journal Article
| Authors: | Yeh, Y. C.; Kadota, K.; Nitadori, J. I.; Sima, C. S.; Rizk, N. P.; Jones, D. R.; Travis, W. D.; Adusumilli, P. S. |
| Article Title: | International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification predicts occult lymph node metastasis in clinically mediastinal node-negative lung adenocarcinoma |
| Abstract: | OBJECTIVES: We investigated the role of the 2011 International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) classification in predicting occult lymph node metastasis in clinically mediastinal nodenegative lung adenocarcinoma. METHODS: We reviewed lung adenocarcinoma patients who had clinically N2-negative status, were evaluated by preoperative positron emission tomography combined with computed tomography (PET/CT) and had undergone lobectomy or pneumonectomy at Memorial Sloan Kettering Cancer Center (n = 297). Tumours were classified according to the 2011 IASLC/ATS/ERS classification. The associations between occult lymph node metastasis and clinicopathological variables were analysed using Fisher's exact test and logistic regression analysis. RESULTS: Thirty-two (11%) cN0-1 patients had occult mediastinal lymph node metastasis (pN2) whereas 25% of cN1 patients had pN2 disease. Increased micropapillary pattern was associated with increased risk of pN2 disease (P = 0.001). On univariate analysis, high maximum standard uptake value of the primary tumour on PET/CT (P = 0.019) and the presence of micropapillary (P = 0.014) and solid pattern (P = 0.014)were associated with occult pN2 disease. On multivariable analysis, micropapillary pattern was positively associated with risk of pN2 disease (odds ratio = 3.41; 95% confidence intervals = 1.42-8.19; P = 0.006). CONCLUSIONS: The presence of micropapillary pattern is an independent predictor of occult mediastinal lymph node metastasis. Our observations have potential therapeutic implications for management of early-stage lung adenocarcinoma. © The Author 2015. |
| Keywords: | metastasis; lung cancer; non-small cell lung cancer; micropapillary; early stage |
| Journal Title: | European Journal of Cardio-Thoracic Surgery |
| Volume: | 49 |
| Issue: | 1 |
| ISSN: | 1010-7940 |
| Publisher: | Oxford University Press |
| Date Published: | 2016-01-01 |
| Start Page: | e9 |
| End Page: | e15 |
| Language: | English |
| DOI: | 10.1093/ejcts/ezv316 |
| PROVIDER: | scopus |
| PMCID: | PMC4678972 |
| PUBMED: | 26377636 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 March 2016 -- Source: Scopus |
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