[Role of CT assessment of mediastinal lymph nodes in the preoperative staging of T1 pulmonary carcinoma].
The utility of the preoperative staging of T1 lung cancer is controversial. This is due to a lower prevalence of N2 metastases in tumors of small diameter. To assess the prevalence of N2 metastases in such tumors and the sensitivity and specificity of computed tomography in mediastinal sadiation, the authors reviewed CT scans and pathology reports of 56 patients who had undergone surgical resection of a T1 lung cancer so distributed: Adenocarcinoma 20 cases, adenosquamous carcinoma 14, Bronchioloalveolar carcinoma 7, Undifferentiated 7, Carcinoid 5, Small cells carcinoma 3. Mediastinal nodal metastases were present in 11 patients: 6 of them were correctly detected by CT scan. Some differences in terms of N2 prevalence and sensitivity were noted when the T1 were divided in two groups of diameter greater or smaller of 2 cm. Important considerations derived after dividing our patients according to the histological type. The prevalence of N2 metastases was greater in adenocarcinoma than in adenosquamous carcinoma but CT sensitivity was lower in adenocarcinoma (40% Vs 100%). The authors conclude that the prevalence of N2 metastases is high enough to request a preoperative sadiation, but the utility of CT in this purpose is limited by a low sensitivity.
Cortale
M
M
Divisione di Chirurgia Toracica Ospedale di Cattinara Trieste.
Arbore
E
E
Braini
A
A
Zaccaria
A
A
Sanna
S
S
Liguori
G
G
D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D009367:Neoplasm Staging; D011300:Preoperative Care; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed