title: Predictive value of primary fluorine-18 fluorodeoxyglucose standard uptake value for a better choice of systematic nodal dissection or sampling in clinical stage ia non--small-cell lung cancer.
abstract: OBJECTIVE
  To determine whether the standard uptake value (SUV) of the primary lesion can predict mediastinal lymph node metastasis in clinical stage IA non--small-cell lung cancer (NSCLC).
  
  
  METHODS
  At 5 centers, patients with clinical stage IA NSCLC from February 2004 to August 2010 were analyzed retrospectively. Data from Shandong Cancer Hospital and from the Cancer Hospital Affiliated to Harbin Medical University were used as a testing set, and data from the other 3 institutions were used as the validation set. Final diagnosis was established based on the histopathologic examination.
  
  
  RESULTS
  Data from 144 patients were collected for the study. The primary results in our study showed that maximal SUV (SUVmax) of primary tumor might be a predictor of lymph node metastasis (χ(2) = 10.424; P = .001) and the best cutoff value was 7.25 (P = .029). For the testing set, lymph node metastasis rates in low-grade group (SUVmax < 7.25) and high-grade group (SUVmax > 7.25) were 5% (2/43) and 36% (9/25) (P = .001) For the total data set, lymph node metastasis rate was 7% (6/93) in low-grade group (SUVmax < 7.25) and 26% (13/51) in high-grade group (SUVmax > 7.25) (χ(2)= 10.424; P = .001). A multivariate analysis revealed that no factors were applied to predict the probability of metastasis. But the analysis showed a weak correlation between SUVmax and nodal status (r = 0.21; P = .011) with bivariate correlation.
  
  
  CONCLUSIONS
  Analysis of our data suggested that fluorine-18 fluorodeoxyglucose SUVmax of the primary tumor might be a predictor of lymph node involvement in stage IA NSCLC. The rate of mediastinal lymph node metastasis of patients with a lower fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography SUVmax might be relatively low, which provides more evidence for clinical procedures of clinical stage IA NSCLC.
authors.affiliation: Department of Radiation Oncology and Key Laboratory of Radiation Oncology of Shandong Province, Department of Radiation Oncology of Shandong Cancer Hospital and Institute, Jinan, Shandong, China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Li
authors.forename: Huaqi
authors.initials: H
authors.lastname: Zhang
authors.forename: Ligang
authors.initials: L
authors.lastname: Xing
authors.forename: Xiangying
authors.initials: X
authors.lastname: Xu
authors.forename: Peng
authors.initials: P
authors.lastname: Xie
authors.forename: Honglian
authors.initials: H
authors.lastname: Ma
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.forename: Ming
authors.initials: M
authors.lastname: Chen
authors.forename: Xindong
authors.initials: X
authors.lastname: Sun
authors.forename: Wengui
authors.initials: W
authors.lastname: Xu
authors.forename: Lusheng
authors.initials: L
authors.lastname: Chen
authors.forename: Jinming
authors.initials: J
authors.lastname: Yu
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Fluorine-18 fluorodeoxyglucose positron emission tomography–computed tomography; Lymph node metastasis; Non–small-cell lung cancer; Standard uptake value; Systematic nodal dissection