Multiparametric evaluation of mediastinal lymph node metastases in clinical T0–T1c stage non-small-cell lung cancers

Abstract

Abstract OBJECTIVES This study aimed to determine the predictive factors of lymph node metastases in clinical T0–T1c stage non-small-cell lung cancers, so as to help making surgical strategy. METHODS From January 2016 to December 2017, patients with clinical T0–T1c stage non-small-cell lung cancers were retrospectively reviewed. We elucidated the lymph node metastatic incidence and distribution according to the primary tumour radiographic findings and maximal standard uptake values, and extracted the associated clinicopathological factors. Univariable and multivariable logistic regressions were used to identify independent predictive parameters for lymph node metastases. The performance of predictive model was evaluated using receiver operating characteristic analysis. RESULTS A total of 517 patients were included. Seventy-two patients had lymph node metastases. Among patients with pure ground-glass nodule and solid component size ≤10 mm, none had any lymph node metastasis. Multivariable logistic regression analysis demonstrated that age, carcinoembryonic antigen level, solid component size, consolidation–tumour ratio and tumour maximal standard uptake values were independent predictors of lymph nodal metastases. Receiver operating characteristic analyses indicated that the area under the curve of predictive model in evaluating lymph node metastases was 0.838 (95% CI 0.791–0.886). CONCLUSIONS Younger age, elevated carcinoembryonic antigen level, larger solid component size, higher consolidation–tumour ratio and tumour maximal standard uptake values were associated with lymph node involvement. Employing such a predictive model in the future may affect the surgical option of lymph node excision for patients in cT1 stage non-small-cell lung cancer.