Postinduction positron emission tomography assessment of N2 nodes is not associated with ypN2 disease or overall survival in stage IIIA non-small cell lung cancer Journal Article
| Authors: | Ripley, R. T.; Suzuki, K.; Tan, K. S.; Adusumilli, P. S.; Huang, J.; Park, B. J.; Downey, R. J.; Rizk, N. P.; Rusch, V. W.; Bains, M.; Jones, D. R. |
| Article Title: | Postinduction positron emission tomography assessment of N2 nodes is not associated with ypN2 disease or overall survival in stage IIIA non-small cell lung cancer |
| Abstract: | Objective Induction therapy is often recommended for patients with clinical stage IIIA-N2 (cIIIA/pN2) lung cancer. We examined whether postinduction positron emission tomography (PET) scans were associated with ypN2 disease and survival of patients with cIIIA/pN2 disease. Methods We performed a retrospective review of a prospectively maintained database to identify patients with cIIIA/pN2 non-small cell lung cancer treated with induction chemotherapy followed by surgery between January 2007 and December 2012. The primary aim was the association between postinduction PET avidity and ypN2 status; the secondary aims were overall survival, disease-free survival, and recurrence. Results Persistent pathologic N2 disease was present in 61% of patients (61 out of 100). PET N2-negative disease increased from 7% (6 out of 92) before induction therapy to 47% (36 out of 77) afterward. The sensitivity, specificity, and accuracy of postinduction PET for identification of ypN2 disease were 59%, 55%, and 57%, respectively. Logistic regression analysis indicated that postinduction PET N2 status was not associated with ypN2 disease. Of the 39 patients with both pre- and postinduction PET N2-avidity, 25 (64%) had ypN2 disease. The 5-year overall survival was 40% for ypN2 disease versus 38% for N2-persistent disease (P =.936); the 5-year overall survival was 43% for postinduction PET N2-negative disease versus 39% for N2-avid disease (P =.251). The 5-year disease-free survival was 34% for ypN2-negative disease versus 9% for N2-persistent disease (P =.079). Conclusions Postinduction PET avidity for N2 nodes is not associated with ypN2 disease, overall survival, or disease-free survival in patients undergoing induction chemotherapy for stage IIIA/pN2 disease. © 2016 The American Association for Thoracic Surgery. |
| Keywords: | surgery; induction; stage iii nsclc |
| Journal Title: | Journal of Thoracic and Cardiovascular Surgery |
| Volume: | 151 |
| Issue: | 4 |
| ISSN: | 0022-5223 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2016-04-01 |
| Start Page: | 969 |
| End Page: | 979.e3 |
| Language: | English |
| DOI: | 10.1016/j.jtcvs.2015.09.127 |
| PROVIDER: | scopus |
| PMCID: | PMC4801676 |
| PUBMED: | 26614420 |
| DOI/URL: | |
| Notes: | Conference Paper -- Read at the 95th Annual Meeting of The American Association for Thoracic Surgery in Seattle, WA on April 25-29, 2015 -- Export Date: 4 April 2016 -- Source: Scopus |
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