P62.06 A Radiomics Nomogram for Preoperative Prediction of Occult Lymph Node Metastasis in Early-Stage Solid Lung Adenocarcinoma

Abstract The standard local treatment for early-stage tongue cancer with no clinical lymph node metastases is partial glossectomy. The frequency of occult lymph node metastasis is ~20–30%. Thus, whether prophylactic neck dissection with glossectomy or glossectomy alone should be performed has been a controversial issue since the 1980s. Both treatments have advantages and disadvantages; however, especially in cases involving prophylactic neck dissection, surgical invasion and complications including the cosmetic disadvantage caused by neck skin incision, accessory nerve paralysis or facial nerve (mandibular marginal branch) paralysis, stiffness of the shoulder or neck and a feeling of neck tightness have been considered issues that could be solved by providing less-invasive treatment to the 70–80% of patients without occult lymph node metastasis. A more accurate preoperative diagnosis and strict follow-up are required to provide minimally invasive treatment while ensuring the therapeutic effect. It is also necessary to narrow down the target based on the risk–benefit balance. The depth of invasion should be considered in cases involving oral cavity malignancies. This was also taken into account in recent revisions of eighth edition of the TNM Classification of Malignant Tumors and it is an important factor for N0 neck management. This review article summarizes previous and recent reports on neck management, focusing on the risk–benefit and future perspectives of the diagnosis and treatment of early-stage oral tongue cancer. This effort is an attempt to establish treatment from the patient’s point of view, with the patient’s quality of life taken into account.

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Novel approach for predicting occult lymph node metastasis in peripheral clinical stage I lung adenocarcinoma

Journal of Thoracic Disease ◽

10.21037/jtd.2019.03.57 ◽

2019 ◽

Vol 11 (4) ◽

pp. 1410-1420 ◽

Cited By ~ 5

Author(s):

Cheng-Yang Song ◽

Daisuke Kimura ◽

Takehiro Sakai ◽

Takao Tsushima ◽

Ikuo Fukuda

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lung Adenocarcinoma ◽

Clinical Stage ◽

Stage I ◽

Node Metastasis ◽

Novel Approach ◽

Occult Lymph Node Metastasis

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Prediction of lymph node metastasis using 5-point visual scale criteria of [18F]-fluoro-2-deoxy-D-glucose on positron emission tomography / computed tomography for early stage lung adenocarcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e21084 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e21084-e21084

Author(s):

Atsushi Kagimoto ◽

Yasuhiro Tsutani ◽

Yoshinori Handa ◽

Takahiro Mimae ◽

Yoshihiro Miyata ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lung Adenocarcinoma ◽

Fdg Pet ◽

Early Stage ◽

Fdg Uptake ◽

Node Metastasis ◽

Deauville Score ◽

Pet Ct ◽

Fdg Pet Ct

e21084 Background: This study aimed to investigate the efficacy of the Deauville criteria, a 5-point visual scale criteria to assess the maximum standardized uptake value (SUVmax) of [18F]-fluoro-2-deoxy-D-glucose (FDG) on positron emission tomography (PET)/computed tomography (CT), in predicting lymph node metastasis and other pathological invasive characteristics of early-stage lung adenocarcinoma. Methods: In this retrospective study including 453 patients undergoing lobectomy or segmentectomy with lymph node dissection for clinical N0 lung adenocarcinoma with a whole size ≤ 3 cm between April 2011 and March 2019, the FDG-PET/CT scans were evaluated using the Deauville criteria to analyze the relationship of Deauville score with the clinicopathological characteristics and prognosis.The scoring method was as follows: Deauville score of 1, no FDG uptake by the primary tumor (same as background); Deauville score of 2, tumor FDG uptake that is the same as or weaker than that of mediastinum; Deauville score of 3, tumor FDG uptake that is stronger than that of mediastinum but same as or weaker than that of liver; Deauville score of 4, tumor FDG uptake that is moderately higher than that of liver; Deauville score of 5, tumor FDG uptake that is markedly stronger than that of liver. Results: The lymph node metastases were present in 0 (0%), 2 (1.1%), 6 (9.5%), 6 (15.8%), and 13 (15.7%) patients with Deauville scores of 1, 2, 3, 4 and 5, respectively. The pathological invasive characteristics (lymphatic, vascular, or visceral pleural invasion) were detected in 2 (2.4%), 17 (9.9%), 18 (28.6%), 23 (60.5%), and 54 (65.1%) patients, respectively. Similar results were found when the study cohort was analyzed according to the institutions where the FDG-PET/CT scans were performed. The 3-year recurrence-free survival was longer in the patients with a Deauville score of 1–2 (97.2%) than those with a Deauville score of 3 (86.2%, p < 0.001) or 4–5 (80.7%, p < 0.001). Conclusions: The 5-point-scale evaluation of the SUVmax on FDG-PET/CT using the Deauville score was useful in predicting not only lymph node metastasis but also other malignancy characteristics of early-stage lung adenocarcinoma.

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