Khirurgiia · 2025
[Prediction of mediastinal nodal metastases based on multivariate analysis of VAMLA results in non-small cell lung cancer patients].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Tukvadze Z G, Esakov Yu S, Efteev L A, Samsonik S A, Kuchevskaya O A, Galkin V N
Аннотация
OBJECTIVE: To analyze risk factors of nodal (N) metastases in patients undergoing video-assisted mediastinal lymphadenectomy (VAMLA).
MATERIAL AND METHODS: Results and clinical efficiency of video-assisted mediastinal lymphadenectomy (VAMLA) were analyzed between August 2020 and December 2024. There were 110 patients. The median of age was 65 years. Men prevailed (90:20). Central cancer was detected in 33 (32.4%) patients. More than half of patients (62.7%) had squamous cell cancer.
RESULTS: Change of clinical stage was noted in 58 patients (52.7%) (decrease - 46 (41.8%), increase - 12 (10.9%) cases). Among 55 patients who underwent PET/CT, false-positive result was detected in 30 (54.5%), false-negative result - in 4 (7.3%) patients, coincidence of stage - in 21 (38.2%) patients. Predictors of metastases were clinical and anatomical form of tumor, histological type of tumor and standardized uptake value (SUV) of mediastinal lymph nodes. After multivariate analysis, we created prognostic model with high discriminatory ability.
CONCLUSION: Clinical and anatomical form of tumor, histological type and SUV of mediastinal lymph nodes have the highest prognostic significance regarding N-metastases of NSCLC. After large-scale studies and clinical validation of prognostic model, these data will clarify the indications for invasive staging based on risk factors and reduce the number of diagnostic interventions.
MATERIAL AND METHODS: Results and clinical efficiency of video-assisted mediastinal lymphadenectomy (VAMLA) were analyzed between August 2020 and December 2024. There were 110 patients. The median of age was 65 years. Men prevailed (90:20). Central cancer was detected in 33 (32.4%) patients. More than half of patients (62.7%) had squamous cell cancer.
RESULTS: Change of clinical stage was noted in 58 patients (52.7%) (decrease - 46 (41.8%), increase - 12 (10.9%) cases). Among 55 patients who underwent PET/CT, false-positive result was detected in 30 (54.5%), false-negative result - in 4 (7.3%) patients, coincidence of stage - in 21 (38.2%) patients. Predictors of metastases were clinical and anatomical form of tumor, histological type of tumor and standardized uptake value (SUV) of mediastinal lymph nodes. After multivariate analysis, we created prognostic model with high discriminatory ability.
CONCLUSION: Clinical and anatomical form of tumor, histological type and SUV of mediastinal lymph nodes have the highest prognostic significance regarding N-metastases of NSCLC. After large-scale studies and clinical validation of prognostic model, these data will clarify the indications for invasive staging based on risk factors and reduce the number of diagnostic interventions.