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Patient Selection of Sublobar Resection Using Visual Evaluation of Positron-Emission Tomography (PET) for Early-Stage Lung Adenocarcinoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study aimed to investigate the efficacy of the Deauville criteria (a 5-point visual scale criteria) in assessing the accumulation of [18F]-fluoro-2-deoxy-d-glucose (FDG) on positron-emission tomography (PET)/computed tomography (CT) for predicting prognosis of early-stage lung adenocarcinoma and selecting candidates for sublobar resection.

Methods

This retrospective study included 648 patients undergoing curative resection for clinical N0 lung adenocarcinoma with a whole tumor size of 3 cm or smaller between April 2007 and March 2019. Accumulations of the FDG on PET/CT scans were scored using the Deauville criteria (Deauville score), and correlations between the Deauville score and prognosis were analyzed.

Results

The recurrence-free survival (RFS) was significantly better for the patients with a Deauville score of 1 or 2 (n = 415, 5-year RFS, 92.6%) than for those with a score of 3 (n = 82, 5-year RFS, 72.7%; P < 0.001) or a score of 4 or 5 (n = 151, RFS, 70.8%; P < 0.001). The RFS did not differ significantly among the patients with Deauville scores of 1 and 2 who underwent wedge resection (n = 102, 5-year RFS, 90.5%), segmentectomy (n = 188, RFS, 95.1%; P = 0.355), and lobectomy (n = 125, RFS, 91.1%; P = 0.462).

Conclusion

The 5-point-scale evaluation of FDG accumulation on PET/CT was useful in predicting the prognosis for patients with early-stage lung adenocarcinoma. Lung adenocarcinoma patients with a whole tumor size of 3 cm or smaller and a Deauville score of 1 or 2 can be candidates for sublobar resection.

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Authors and Affiliations

  1. Department of Surgical Oncology, Hiroshima University Hospital, Hiroshima, Japan

    Atsushi Kagimoto MD, Yasuhiro Tsutani MD, PhD, Yoshinori Handa MD, Takahiro Mimae MD, PhD, Yoshihiro Miyata MD, PhD & Morihito Okada MD, PhD

Authors
  1. Atsushi Kagimoto MD
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  2. Yasuhiro Tsutani MD, PhD
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  3. Yoshinori Handa MD
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  4. Takahiro Mimae MD, PhD
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  5. Yoshihiro Miyata MD, PhD
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  6. Morihito Okada MD, PhD
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Correspondence to Morihito Okada MD, PhD.

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Kagimoto, A., Tsutani, Y., Handa, Y. et al. Patient Selection of Sublobar Resection Using Visual Evaluation of Positron-Emission Tomography (PET) for Early-Stage Lung Adenocarcinoma. Ann Surg Oncol 28, 2068–2075 (2021). https://doi.org/10.1245/s10434-020-09150-w

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  • DOI: https://doi.org/10.1245/s10434-020-09150-w

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