Comparison of integrated positron emission tomography/computed tomography and mediastinoscopy in mediastinal staging of nonsmall cell lung cancer: analysis of 212 patients
Küçük Resim Yok
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Royal Belgian Society for Surgery
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Background : Mediastinal staging is crucial to determine the prognosis and treatment options for patients with non-small cell lung cancer (NSCLC). In this study, we compared the results of integrated positron emission tomography-computerised tomography (PET/CT) with those of mediastinoscopy in mediastinal staging of NSCLC patients. Methods : PET/CT and mediastinoscopy was performed on 250 consecutive patients diagnosed with NSCLC between September 2005 and March 2008. Thirty-eight patients were excluded from the study. Standard cervical mediastinoscopy was performed in all patients, and simultaneous extended cervical mediastinoscopy was performed in 52 patients with left sided lesions. Patients with negative mediastinoscopy underwent resection. The pathological results were correlated with PET/CT findings. Results : A total of 212 patients (199 male, 13 female ; mean age : 58.3 years) were evaluated. In PET/CT analysis 60 true-positive, 45 false-positive, 103 true-negative and 4 false-negative patients were found. The rate of PET/CT positivity of mediastinal lymph nodes was 49.5%. The sensitivity, specificity, positive and negative predictive values and accuracy for PET/CT were 93.8%, 69.6%, 57.1%, 96.3% and 76.9% respectively. The incidence of N2 disease in NSCLC patients with negative mediastinal lymph node uptake on PET/CT was 3.7% (4 of 107). In univariate analysis, right upper lobe tumours were significantly (p < 0.05) more associated with occult N2 disease. Conclusions : In patients with positive mediastinal lymph node uptake on PET/CT invasive mediastinal staging appears necessary for exact staging. Mediastinoscopy can be omitted in NSCLC patients with negative mediastinal uptake on PET/CT in regions where the rate of PET/CT positivity of mediastinal lymph nodes is high.
Açıklama
Anahtar Kelimeler
Kaynak
Acta Chirurgica Belgica
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
112
Künye
İskender, I., Kapıcıbaşı, H. O., Kadıoğlu, S. Z., Sevilgen, G., Tezel, C., Koşar, A., Atasalihli, A. ve Kir, A. (2012). Comparison of integrated positron emission tomography/computed tomography and mediastinoscopy in mediastinal staging nonsmall cell lung cancer: Analysis of 212 patients. Acta Chirurgica Belgica. 112, s. 219-225.
