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Solid part size is an important predictor of nodal metastasis in lung cancer with a subsolid tumor

Authors
 Jun Yeun Cho  ;  Cho Sun Leem  ;  Youlim Kim  ;  Eun Sun Kim  ;  Sang Hoon Lee  ;  Yeon Joo Lee  ;  Jong Sun Park  ;  Young-Jae Cho  ;  Jae Ho Lee  ;  Choon-Taek Lee  ;  Ho Il Yoon 
Citation
 BMC PULMONARY MEDICINE, Vol.18 : 151, 2018 
Journal Title
 BMC PULMONARY MEDICINE 
Issue Date
2018
Keywords
Lymphatic metastasis ; Non-small cell lung Cancer ; Risk factor
Abstract
BACKGROUND: Candidates for preoperative or intraoperative nodal assessment among patients with non-small cell lung cancer (NSCLC) manifesting as a subsolid tumor are not established. The present study was conducted to demonstrate the distribution of nodal metastasis rate according to newly proposed T categories for subsolid tumors, and we further aimed to identify radiologic parameters that can be predictive of nodal metastasis. METHODS: We retrospectively reviewed cases of NSCLC manifesting as a subsolid tumor in computed tomography scans in a university-affiliated tertiary hospital between April 2013 and August 2016. All patients underwent mediastinal lymph node dissection during resection surgery. Multivariate analysis was performed among clinical and radiologic parameters. RESULTS: Of the 269 eligible patients, T-categories were classified as cTis (n = 23, 8.6%), cT1 (n = 203, 75.5%), and cT2 (n = 43, 16.0%). Ten patients (3.7%) had nodal metastasis: pN1 (n = 5, 1.9%), pN2 (n = 5, 1.9%). Nodal metastasis was not observed in tumors with a solid part ≤1.0 cm (cT1mi and cT1a) or in nonsolid tumors ≤3.0 cm (cTis). The nodal metastasis rate in cT1b, cT1c, and cT2 tumors was 6.1% (4/65), 8.3% (1/12), and 11.7% (5/43), respectively. Multivariate analysis showed that a solid part size > 1.5 cm [odds ratio, 5.89; 95% confidence interval, 1.25-27.68, p = 0.025] was significantly associated with nodal metastasis. CONCLUSIONS: We observed nodal metastasis from cT1b tumors (solid part size > 1 cm) among proposed T categories for subsolid tumors and a solid part size is an important radiologic parameter predictive of nodal metastasis in NSCLC manifesting as a subsolid tumor. Considering the low rate of nodal metastasis, pathologic nodal assessment may be unnecessary in early T category tumors with a small solid part size.
Files in This Item:
T201803920.pdf Download
DOI
10.1186/s12890-018-0709-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165385
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