PMID- 28666761
OWN - NLM
STAT- MEDLINE
DCOM- 20190408
LR  - 20190408
IS  - 1938-0690 (Electronic)
IS  - 1525-7304 (Linking)
VI  - 19
IP  - 1
DP  - 2018 Jan
TI  - FDG PET/CT Overcomes Discordance Between Clinical and Pathologic TNM 
      Classification of Small-size Primary Lung Cancer: Influence on Postoperative 
      Prognosis.
PG  - e37-e45
LID - S1525-7304(17)30170-5 [pii]
LID - 10.1016/j.cllc.2017.05.021 [doi]
AB  - INTRODUCTION: We aimed to determine the concordance between the clinical stage 
      (c-stage) and pathologic stage (p-stage) for patients with small-size lung 
      cancer. Additionally we searched for prognostic factors other than the TNM stage. 
      PATIENTS AND METHODS: We retrospectively reviewed the preoperative multidetector 
      computed tomography (CT) and positron emission tomography/CT reports, surgical 
      records, and pathologic reports of patients with primary lung cancer </= 3 cm. The 
      Union for International Cancer Control TNM seventh edition classification of 
      c-stage and p-stage were compared. The tumors were classified into multiple 
      subgroups by concordance or discordance between the c-stage and p-stage. 
      Disease-free survival (DFS) was assessed using survival analysis to assess the 
      tumor characteristics that were predictive of prognosis. RESULTS: A total of 289 
      surgically resected primary lung cancers were evaluated. The concordance between 
      c-stage and p-stage was 65.4%, with moderate reproducibility (kappa coefficient, 
      0.467). The upstaging rate from c-stage I to p-stage II-IV was 9.4%, and these 
      patients had significantly worse DFS than those with a concordant stage I 
      classification (P < .001). The main reason for upstaging was an underestimation 
      of metastases to the hilar lymph nodes (n = 7) or mediastinal lymph nodes (n = 
      11). A multivariate Cox proportional hazards model showed that the significant 
      predictive factors for DFS were p-stage (hazard ratio, 1.342; P = .003) and 
      maximum standardized uptake value on positron emission tomography/CT (hazard 
      ratio, 12.162; P = .001). CONCLUSION: The concordance rate between c-stage and 
      p-stage for small primary lung cancers had moderate reproducibility. Discordance 
      between c-stage I and p-stage II-IV significantly affected DFS. The maximum 
      standardized uptake value of the primary lesion was an independent prognostic 
      factor, and combining it with c-stage might improve the prediction of therapeutic 
      outcomes.
CI  - Copyright (c) 2017 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Umakoshi, Hiroyasu
AU  - Umakoshi H
AD  - Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Iwano, Shingo
AU  - Iwano S
AD  - Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. Electronic address: iwano45@med.nagoya-u.ac.jp.
FAU - Yokoi, Kohei
AU  - Yokoi K
AD  - Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Ito, Shinji
AU  - Ito S
AD  - Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Ito, Rintaro
AU  - Ito R
AD  - Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Kawaguchi, Koji
AU  - Kawaguchi K
AD  - Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Fukui, Takayuki
AU  - Fukui T
AD  - Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Naganawa, Shinji
AU  - Naganawa S
AD  - Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170608
PL  - United States
TA  - Clin Lung Cancer
JT  - Clinical lung cancer
JID - 100893225
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*diagnosis/mortality/pathology
MH  - Male
MH  - Middle Aged
MH  - Multidetector Computed Tomography/*methods
MH  - Neoplasm Staging
MH  - Positron Emission Tomography Computed Tomography/*methods
MH  - Postoperative Period
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Survival Analysis
OTO - NOTNLM
OT  - Computed Tomography
OT  - Disease-free survival
OT  - Positron emission tomography
OT  - Prognostic factors
OT  - Staging
EDAT- 2017/07/02 06:00
MHDA- 2019/04/09 06:00
CRDT- 2017/07/02 06:00
PHST- 2017/03/14 00:00 [received]
PHST- 2017/05/26 00:00 [revised]
PHST- 2017/05/30 00:00 [accepted]
PHST- 2017/07/02 06:00 [pubmed]
PHST- 2019/04/09 06:00 [medline]
PHST- 2017/07/02 06:00 [entrez]
AID - S1525-7304(17)30170-5 [pii]
AID - 10.1016/j.cllc.2017.05.021 [doi]
PST - ppublish
SO  - Clin Lung Cancer. 2018 Jan;19(1):e37-e45. doi: 10.1016/j.cllc.2017.05.021. Epub 
      2017 Jun 8.