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Thorac Cardiovasc Surg 2021; 69(04): 380-386
DOI: 10.1055/s-0040-1721677
Original Thoracic

Positron Emission Tomography in Segmentectomy for cT1N0M0 Nonsmall Cell Lung Cancer

Hiroaki Nomori
1   Department of Thoracic Surgery, Kashiwa Kousei General Hospital, Chiba, Japan
,
Yoichi Machida
2   Department of Radiology, Kameda Medical Center, Chiba, Japan
,
Ikuo Yamazaki
2   Department of Radiology, Kameda Medical Center, Chiba, Japan
,
Koichi Honma
3   Department of Pathology, Kameda Medical Center, Chiba, Japan
,
Ayumu Otsuki
4   Department of Pulmonary Medicine, Kameda Medical Center, Chiba, Japan
,
Yue Cong
5   Department of Thoracic Surgery, Kameda Medical Center, Chiba, Japan
,
Hiroshi Sugimura
5   Department of Thoracic Surgery, Kameda Medical Center, Chiba, Japan
,
Yu Oyama
6   Department of Medical Oncology, Kameda Medical Center, Chiba, Japan
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Abstract

Background This study was aimed to examine the significance of fluorodeoxyglucose positron emission tomography in predicting prognosis after segmentectomy in lung cancer.

Methods This was a retrospective cohort study, including 227 patients with cT1N0M0 nonsmall cell lung cancer who underwent positron emission tomography followed by segmentectomy between 2012 and 2019. Significance of tumor histology, T-stage, tumor size, and standardized uptake value on positron emission tomography in relation to recurrence-free survival were examined using Cox's proportional hazard analysis. Median follow-up period was 56 months (range: 1–95 months).

Results Tumor stages were Tis in 25 patients, T1mi/T1a in 51, T1b in 98, and T1c in 53. Twenty-six patients (11%) experienced recurrences, including local (n = 8) and distant (n = 18). Multivariate analysis showed that the significant variables for recurrence-free survival were T-stage and standardized uptake value (p = 0.002 and 0.015, respectively), whereas tumor histology and tumor size were not significant (p = 0.28 and 0.44, respectively). When tumor size was divided into ≤2 cm and >2 cm for analysis, it was not significant again (p = 0.49), whereas standardized uptake value remained significant (p = 0.008). While standardized uptake value of tumors with recurrences was significantly higher than those without (4.9–2.8 and 2.6–2.5, respectively, p < 0.001), there was no significant difference between local and distant recurrences (p = 0.32). Cut-off value of standardized uptake value for recurrences was 3.2. Five-year recurrence-free survival rates in tumors with standardized uptake value <3.2 and ≥3.2 were 86 and 65%, respectively (p < 0.001).

Conclusion Positron emission tomography could predict the prognosis after segmentectomy better than tumor size.

Keywords

lung cancer - segmentectomy - positron emission tomography - recurrence - survival

Note

Date and number of Institutional Review Board approval: February in 2014 (approval number: 14–003).


Supplementary Material



Publication History

Received: 13 August 2020

Accepted: 26 October 2020

Article published online:
12 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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