title: T1 non-small cell lung cancer: imaging and histopathologic findings and their prognostic implications.
abstract: About 5% of T1 non-small cell lung cancers (ie, lung cancers less than 3 cm in diameter), mostly focal nodular bronchioloalveolar carcinomas and carcinoid tumors, demonstrate no uptake at fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and appear to be indolent in growth; consequently, they are associated with long-term patient survival. About 21% of T1 lung cancers show mediastinal nodal metastasis at the time of diagnosis and about 24% show extrathoracic metastasis, mostly brain metastasis, either at the time of diagnosis or at 1-year follow-up. T1 lung cancers with a large ground-glass attenuation component (50% of tumor volume) at thin-section computed tomography (CT) have a good prognosis with less likelihood of mediastinal nodal or extrathoracic metastasis. On the other hand, solid cancer lesions, especially those with a spiculated margin or with bronchovascular bundle thickening in the surrounding lung, more frequently demonstrate local vessel invasion, lymph node metastasis, and extrathoracic metastasis. In these tumors, work-up for extrathoracic metastases (including whole-body FDG PET or brain magnetic resonance imaging and mediastinoscopy for mediastinal nodes) may be needed, even when CT demonstrates no enlarged nodes in the mediastinum.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea. melon2@samsung.co.kr
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Yeon Joo
authors.initials: YJ
authors.lastname: Jeong
authors.forename: Joungho
authors.initials: J
authors.lastname: Han
authors.forename: Byung-Tae
authors.initials: BT
authors.lastname: Kim
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality*; D000328:Adult; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18