title: Prediction of lymph node status in clinical stage IA squamous cell carcinoma of the lung.
abstract: OBJECTIVE
  This multicentre study aimed to investigate the predictors of pathological lymph node status in patients with clinical stage IA squamous cell carcinoma of the lung, to select candidates for sublobar resection.
  
  
  METHODS
  In total, we analysed 100 patients with clinical stage IA squamous cell carcinoma of the lung who underwent lobectomy or segmentectomy with systematic lymph node dissection. The relationship between lymph node status and tumour size on computed tomography, maximum standardized uptake value (SUV) on [18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) and serum tumour markers were examined.
  
  
  RESULTS
  Lymph node metastases were present in 12% of the study subjects, and 54% had evidence of pathological tumour invasiveness such as lymph node metastasis and/or lymphatic, vascular or pleural invasion. The areas under the receiver operating characteristic (ROC) curves for tumour size, maximum SUV, serum carcinoembryonic antigen and serum cytokeratin-19 fragments used to predict lymph node metastasis were 0.54 (P = 0.69), 0.46 (P = 0.67), 0.47 (P = 0.74) and 0.42 (P = 0.37), respectively. After multivariate analysis, no independent predictive factors for lymph node metastasis remained among those preoperative parameters. Likewise, we could find no preoperative predictors from either the ROC curves or multivariate analysis for pathological tumour invasiveness.
  
  
  CONCLUSIONS
  All examined factors in this dataset were not predictive for lymph node metastasis or pathological invasiveness in patients with clinical stage IA squamous cell carcinoma of the lung. Systematic lymphadenectomy is advisable for this type of tumour.
authors.affiliation: Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsutani
authors.affiliation: Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Murakami
authors.affiliation: Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyata
authors.affiliation: Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Nakayama
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshimura
authors.affiliation: Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan morihito@hiroshima-u.ac.jp.
authors.forename: Morihito
authors.initials: M
authors.lastname: Okada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor
keywords: Computed tomography; Lymph node metastasis; Non-small-cell lung cancer; Positron emission tomography; Squamous cell carcinoma; Tumour marker