title: Preoperative computed tomography of the chest in lung cancer patients: the predictive value of calcified lymph nodes for the perioperative outcomes of video-assisted thoracoscopic surgery lobectomy.
abstract: OBJECTIVE
  To determine the predictive value of identifying calcified lymph nodes (LNs) for the perioperative outcomes of video-assisted thoracoscopic surgery (VATS).
  
  
  METHODS
  Fifty-six consecutive patients who underwent VATS lobectomy for lung cancer were included. We evaluated the number and location of calcified LNs on computed tomography (CT). We investigated clinical parameters, including percentage forced expiratory volume in 1 s (FEV1%), surgery duration, chest tube indwelling duration, and length of hospital stay. We performed linear regression analysis and multiple comparisons of perioperative outcomes.
  
  
  RESULTS
  Mean number of calcified LNs per patient was 0.9 (range, 0-6), mostly located in the hilar-interlobar zone (43.8 %). For surgery duration (mean, 5.0 h), FEV1% and emphysema severity were independent predictors (P = 0.010 and 0.003, respectively). The number of calcified LNs was an independent predictor for chest tube indwelling duration (P = 0.030) and length of hospital stay (P = 0.046). Mean duration of chest tube indwelling and hospital stay was 8.8 days and 12.7 days in no calcified LN group; 9.2 and 13.2 in 1 calcified LN group; 12.8 and 19.7 in ≥2 calcified LNs group, respectively.
  
  
  CONCLUSIONS
  The presence of calcified LNs on CT can help predict more complicated perioperative course following VATS lobectomy.
authors.affiliation: Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Kwang Nam
authors.initials: KN
authors.lastname: Jin
authors.forename: Hyeon-Jong
authors.initials: HJ
authors.lastname: Moon
authors.forename: Yong Won
authors.initials: YW
authors.lastname: Sung
authors.forename: Youkyung
authors.initials: Y
authors.lastname: Lee
authors.forename: Jae Yeon
authors.initials: JY
authors.lastname: Wi
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007902:Length of Stay; D016014:Linear Models; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011656:Pulmonary Emphysema / Q000150:complications / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult