Ümit Özgür AKDEMİR, İrfan TAŞTEPE, Murat TÜRK, Ahmet Selim YURDAKUL, Fatma YILDIRIM

T1-2NOMO Küçük Hücreli Dışı Akciğer Kanseri Hastalarında Primer Tümör Metabolik Aktivitesi Gizli Lenf Nodu Metastazı için Risk Faktörü müdür?

Amaç: Çalışmamızın amacı, pozitron emisyon-bilgisayarlı tomografi (PET-BT) ile klinik evre 1 olarak evrelendirilmiş küçük hücreli dışı akciğer kanseri (KHDAK) hastalarında gizli lenf nodu metastazı için potansiyel risk faktörlerini incelemektir. Yöntemler: Torasik Onkoloji ünitemizde PET-BT ile klinik olarak Evre I KHDAK tanısı konmuş ve cerrahi uygulanmış, sistemik lenf nodu örneklemesi yapılmış 26 hastanın dosyaları retrospektif olarak incelendi. Hastaların demografik özellikleri, cerrahi yapılana kadar geçen süre, tümörün histolojik tipi, diferansiasyon derecesi, lokalizasyonu, PET/BT'deki çapı, cerrahi çapı ve SUVmax değeri kaydedildi. Gizli lenf nodu metastazı için olabilecek risk faktörleri incelendi. Hastalar PET/BT'deki tümörün çapı ve SUVmax değerine göre üç gruba ayrıldı: grup 1 (düşük riskli grup) T

Is Primary Tumor Metabolic Activity a Risk Factor for Occult Lymph Node Metastasis in T1-2N0M0 Non-small Cell Lung Cancer Patients?

Objective: In our study we aimed to evaluate the potential risk factors for occult lymph node metastasis with PET-CT in patients with clinically stage I NSCLC. Methods:Hospital records of 26 patients who were clinically diagnosed with stage 1 NSNLC in our unit with PET-CT, operated and underwent systemic lymph node dissection were retrospectively analysed. Demographic features, time to surgery and histologic type, differentiation grade, localisation, diameter at PET-CT and SUVmax values of the tumor were recorded. The patients were divided into three groups according to the diameter and the median SUVmax value of the primary mass at PET/CT: Group 1 (low risk group) T

PDF

___

Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics. CA Cancer J Clin 2006;56:106-130.
Felip E, Stahel RA, Pavlidis N; ESMO Guidelines Task Force. ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of non-small-cell lung cancer (NSCLC). Ann Oncol 2005;16:28-9.
Detterbeck FC, Asamura H, Crowley J, Falkson C, Giaccone G, Giroux D et al. The new lung cancer staging system. Chest 2009;136:260-71.
vanTinteren H, Hoekstra OS, Smit EF, van den Bergh JH, Schreurs AJ, Stallaert RA et al. Effectiveness of PET in the preoperative assessment of patients with suspected non-smallcell lung cancer: The PLUS multi center randomised trial. Lancet 2002;359:1388- 92.
Reed CE, Harpole DH, Posther KE, Woolson SL, Downey RJ, Meyers BF et al. Results of the American college of surgeons' oncology group Z0050 trial: the utility of positron emission tomography in staging potentially operable non-small cell lung cancer. J Thorac Cardiovasc Surg 2003;126(6):1943-51.
Veeramachaneni NK, Battafarano RJ, Meyers BF, Zoole JB, Patterson GA. Risk factors for occult nodal metastasis in clinical T1N0 lung cancer: a negative impact on survival. Eur J Cardiothorac Surg 2008;33:466-9.
Herth FJ, Eberhardt R, Krasnik M, Ernst A.Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically and positron emission tomography- normal mediastinum in patients with lung cancer. Chest 2008;133:887-91.
Casiraghi M, Travaini LL, Maisonneuve P, Tessitore A, Brambilla D, Agoglia BGet al. Lymph node involvement in T1 non-small-cell lung cancer: could glucose uptake and maximal diameter be predictive criteria? Eur J Cardiothorac Surg 2011;39:e38-43.
Li M, Liu N, Hu M, Shi F, Yuan S, Zhang Pet al. Relationshipbetweenprimarytumorfluorodeoxyglucose and nodal ordistantmetastases at presentation in T1 stagenon- smallcelllungcancer. LungCancer 2009;63:383-6. uptake
Higashi K, Ito K, Hiramatsu Y, Ishikawa T, Sakuma T, Matsunari I et al. 18F-FDG uptake by primary tumor as a predictor of intratumoral lymphatic vessel invasion and lymph node involvement in non-small cell lung cancer: analysis of a multicenter study. J Nucl Med 2005;46:267-73.
Rami-Porta R, Crowley JJ, Goldstraw P. The revised TNM staging system for lung cancer. Ann Thorac Cardiovasc Surg 2009;15(1):4- 9.
Travis WD, Brambilla E, Riely GJ. New pathologic classification of lung cancer: relevance for clinical practice and clinical trials. J Clin Oncol. 2013;31(8):992-1001.
Lee PC, Port JL, Korst RJ, Liss Y, Meherally DN, Altorki NK. Risk factors for occult mediastinal metastases in clinical stage I non- small cell lung cancer. Ann Thorac Surg 2007;84(1):177-81.
Kanzaki R, Higashiyama M, Fujiwara A, Tokunaga T, Maeda J, Okami Jet al. Occult mediastinal lymph node metastasis in NSCLC patients diagnosed as clinical N0-1 by preoperative integrated FDG PET/CT and CT: Risk factors, pattern, and histopathological study. Lung Cancer 2011;71(3):333-7.
Gómez-Caro A, Garcia S, Reguart M, Gimferrer JM et al. Incidence of occult mediastinal node involvement in cN0 non-small cell lung cancer patients after negative uptake of positron emission tomography/computed tomography scan. Eur J Cardiothorac Surg 2010;37:1168-74.
Park HK, Jeon K, Koh WJ, Suh GY, Kim H, Kwon OJet al. Occult nodal metastasis in patients with non-small cell lung cancer at clinical stage IA by PET/CT. Respirology 2010;15:1179-84. GMJ 2016; 27: 71-75