Radioisotope-Guided Excision of Mediastinal Lymph Nodes in Patients with Non-Small Cell Lung Carcinoma: Feasibility and Clinical Impact
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Lymphoscintigraphy and Surgery
2.3. Statistical Analysis
3. Results
3.1. Patients’ Population
3.2. Distribution of Metastases in SLNs and nSLNs
3.3. Lymphatic Pathing
3.4. Predictors of Lymph Nodes Localisations and of eSLNs
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patients, n | 48 | Mean injected activity, MBq (IQR) | 31.5 (5) | ||
Sex, n | 17 F (35%) | 31 M (65%) | |||
Mean age, years (IQR) | 69 (12) | Dissected lymph nodes, n | Total | 290 | |
SLNs | 179 (62%) | ||||
Smoking habit, n | Yes | 37 (77%) | nSLNs | 87 (30%) | |
No | 11 (23%) | eSLNs | 24 (8%) | ||
Histoype, n | Adenocarcinoma | 34 (71%) | Metastatic lymph nodes, n | Total | 44 |
Squamous cells | 14 (29%) | SLNs | 36 (82%) | ||
Neoadjuvant treatment, n | Yes | 10 (21%) | nSLNs | 8 (18%) | |
No | 38 (79%) | eSLNs | 0 (0%) | ||
Clinical T (cT) staging, n | cT1 | 14 (29%) | Pathological T (pT) staging, n | pT1 | 15 (31%) |
cT2 | 16 (33%) | pT2 | 18 (38%) | ||
cT3 | 15 (31%) | pT3 | 9 (19%) | ||
cT4 | 3 (6%) | pT4 | 6 (12%) | ||
Clinical N (cN) staging, n | cN0 | 25 (52%) | Pathological N (pN) staging, n | pN0 | 26 (54%) |
cN1 | 10 (21%) | pN1 | 9 (19%) | ||
cN2 | 13 (27%) | pN2 | 13 (27%) |
Patient # | Primary Localization | Histotype | cTNM, yTNM | Positive SLN Stations | Positive nSLN Stations | Negative SLN Stations |
---|---|---|---|---|---|---|
31 | Left lung | Squamous cells | cT2N2 | Within the left lung | Subaortic | Left hilus, subcarinal, paraesophageal |
37 | Left upper lobe | Adenocarcinoma | cT2N1 | Subaortic | Para-aortic, left hilus, subcarinal, paraesophageal | Within the left upper lobe |
47 | Right upper lobe | Adenocarcinoma | cT3N2, yT2N2 | Within the right upper lobe, upper/lower tracheal right, subcarinal | Anterior mediastinum, upper tracheal right, upper tracheal corner | Lower tracheal left |
Nodal Staging | Number of Patients | Number of Metastases in SLNs | Number of Metastases in nSLNs | Skip Metastases |
---|---|---|---|---|
cN0 | 25 | 5 | None | 1 * |
cN1 | 10 | 5 | 4 | None |
cN2 | 13 | 26 | 4 | 1 * |
Parameter | OR | Significance | LB | UB |
---|---|---|---|---|
Sex (male) | 8.273 | 0.065 | 0.875 | 78.204 |
Neoadjuvant chemotherapy | 12.882 | 0.078 | 0.753 | 220.279 |
cN0 | Reference | |||
cN1 | 9.665 | 0.083 | 0.746 | 125.195 |
cN2 | 17.506 | 0.021 | 1.548 | 198.031 |
Parameter | OR | Significance | LB | UB |
---|---|---|---|---|
Neoadjuvant chemotherapy | 0.17 | 0.159 | 0.015 | 1.996 |
Uptake time (>median) | 0.227 | 0.029 | 0.06 | 0.862 |
cN0 | Reference | |||
cN1 | 0.737 | 0.783 | 0.084 | 6.439 |
cN2 | 0.653 | 0.645 | 0.107 | 4.1 |
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Pini, C.; Bottoni, E.; Fiz, F.; Giudici, V.M.; Alloisio, M.; Testori, A.; Rodari, M.; Sollini, M.; Chiti, A.; Cariboni, U.; et al. Radioisotope-Guided Excision of Mediastinal Lymph Nodes in Patients with Non-Small Cell Lung Carcinoma: Feasibility and Clinical Impact. Cancers 2023, 15, 3320. https://doi.org/10.3390/cancers15133320
Pini C, Bottoni E, Fiz F, Giudici VM, Alloisio M, Testori A, Rodari M, Sollini M, Chiti A, Cariboni U, et al. Radioisotope-Guided Excision of Mediastinal Lymph Nodes in Patients with Non-Small Cell Lung Carcinoma: Feasibility and Clinical Impact. Cancers. 2023; 15(13):3320. https://doi.org/10.3390/cancers15133320
Chicago/Turabian StylePini, Cristiano, Edoardo Bottoni, Francesco Fiz, Veronica Maria Giudici, Marco Alloisio, Alberto Testori, Marcello Rodari, Martina Sollini, Arturo Chiti, Umberto Cariboni, and et al. 2023. "Radioisotope-Guided Excision of Mediastinal Lymph Nodes in Patients with Non-Small Cell Lung Carcinoma: Feasibility and Clinical Impact" Cancers 15, no. 13: 3320. https://doi.org/10.3390/cancers15133320