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An accurate prediction of negative lymph node metastasis with consideration of glucose metabolism in early-stage non-small cell lung cancer

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Abstract

Objective

We aimed to identify risk factors in lymph node metastasis in early-stage non-small cell lung cancer (NSCLC) and predict lymph node metastasis.

Methods

A total of 416 patients with clinical stage IA2-3 NSCLC who underwent lobectomy and lymph node dissection between July 2016 and December 2020 at National Cancer Center Hospital East were included. Multivariable logistic regression was performed to develop a model for predicting lymph node metastasis. Leave-one-out cross-validation was performed to evaluate the developing prediction model, and sensitivity, specificity, and concordance statistics were calculated to evaluate its diagnostic performance.

Results

The formula for calculating the probability of pathological lymph node metastasis included SUVmax of the primary tumor and serum CEA level. The concordance statistics was 0.7452. When the cutoff value associated with the risk of incorrectly predicting pathological lymph node metastasis was 7.2%, the diagnostic sensitivity and specificity for predicting metastasis were 96.4% and 38.6%, respectively.

Conclusions

We created a prediction model for lymph node metastasis in NSCLC by combining the SUVmax of the primary tumor and serum CEA levels, which showed a particularly strong association. This model is clinically useful as it successfully predicts negative lymph node metastasis in patients with clinical stage IA2-3 NSCLC.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We sincerely appreciate all the patients and their families who were included in this retrospective study.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa, Chiba, 277-8577, Japan

    Ken Onodera, Keiju Aokage, Tomohiro Miyoshi, Kenta Tane, Joji Samejima & Masahiro Tsuboi

  2. Biostastics Division, Center for Research Administration and Support, National Cancer Center Hospital East, Kashiwa, Japan

    Masashi Wakabayashi

  3. Clinical Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan

    Takashi Ikeno

  4. Division of Diagnostic Radiology, National Cancer Center Hospital East, Kashiwa, Japan

    Takahiro Morita

  5. Division of Radiation Technology, National Cancer Center Hospital East, Kashiwa, Japan

    Shuhei Ohashi

Authors
  1. Ken Onodera
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  2. Keiju Aokage
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  3. Masashi Wakabayashi
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Correspondence to Ken Onodera.

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Onodera, K., Aokage, K., Wakabayashi, M. et al. An accurate prediction of negative lymph node metastasis with consideration of glucose metabolism in early-stage non-small cell lung cancer. Gen Thorac Cardiovasc Surg 72, 24–30 (2024). https://doi.org/10.1007/s11748-023-01946-3

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  • DOI: https://doi.org/10.1007/s11748-023-01946-3

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