Significance of smoking history and FDG uptake for pathological N2 staging in clinical N2-negative non-small-cell lung cancer |
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Institution: | 1. Department of Internal Medicine;2. Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences;3. Department of Nuclear Medicine, Korea University Medical Center Anam Hospital, Seoul;4. Department of Radiology;5. Department of Pathology;6. Thoracic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea |
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Abstract: | BackgroundThis study was conducted to evaluate whether smoking history and the standardized uptake value (SUV) of 2-fluorine-18]fluoro-2-deoxy-D-glucose (FDG) uptake are associated with unexpected pathological N2 status (pN2) in non-small-cell lung cancer (NSCLC).Patients and methodsWe analyzed the data of 220 patients who underwent surgical resection with clinical N2-negative status on computed tomography (CT) and positron emission tomography (PET)–CT. The maximum SUV of primary tumor was chosen for logistic analysis.ResultsSeventy-two patients (33%) had never smoked. The SUV ranged from 1.0 to 29.0 (median 9.1). In univariate analysis, adenocarcinomas (P = 0.019), female gender (P = 0.010), N1 on CT (P = 0.025), and N1 PET–CT (P = 0.001) were associated with a high probability of pN2. The proportion of pN2 in never smokers was higher than in ever smokers (26% versus 10% respectively; P = 0.002). The SUV remained on a multivariate logistic model (odds ratio 1.1; 95% confidence interval 1.0–1.2; P = 0.010) and it had a better predictive value in never smokers than in ever smokers (P = 0.017).ConclusionsThis study indicates an association between smoking history and pN2 in clinically negative N2 NSCLC. The different roles of FDG uptake were also suggested based on smoking history. |
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