Original investigation
Published: 2017-03-15

Routine invasive mediastinal staging of lung cancer in elderly patients without lymph adenopathy on PET-CT scan: is an appropriate choice?

Thoracic Surgery Unit, Second University of Naples, Italy
Thoracic Surgery Unit, Second University of Naples, Italy
Thoracic Surgery Unit, Second University of Naples, Italy
Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Hospital Monaldi, Naples, Italy
Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Hospital Monaldi, Naples, Italy
Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Hospital Monaldi, Naples, Italy
Thoracic Surgery Unit, Second University of Naples, Italy
CT/PET Invasive technique Mediastinal staging Non small cell lung cancer

Abstract

We have reviewed the literature to clarify if routine invasive mediastinal staging is indicated also in Stage I elderly
patients screened with PET/CT scan. Nineteen papers were chosen to answer the question. Occult pN2 disease
was < 10% in five papers; between 10-16% in four papers; and > 16% in four papers.Significant risk factors for
occult pN2 disease are the SUV value of primary tumor (seven papers), central tumor (four papers), tumor > 3
cm (five papers), adenocarcinoma histology (five papers) and cN1 disease(two papers). Two papers found that
unexpected pN2 patients had a better survival than cN2 patients operated after induction therapy. Invasive mediastinal
staging is recommended also in cN0 patients with central tumor or with peripheral tumor > 3 cm.

Affiliations

A. Fiorelli

Thoracic Surgery Unit, Second University of Naples, Italy

A. Mazzella

Thoracic Surgery Unit, Second University of Naples, Italy

M. Pierdiluca

Thoracic Surgery Unit, Second University of Naples, Italy

F. Perrotta

Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Hospital Monaldi, Naples, Italy

G. Mazzarella

Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Hospital Monaldi, Naples, Italy

A. Bianco

Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Hospital Monaldi, Naples, Italy

M. Santini

Thoracic Surgery Unit, Second University of Naples, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2017

How to Cite

[1]
Fiorelli, A., Mazzella, A., Pierdiluca, M., Perrotta, F., Mazzarella, G., Bianco, A. and Santini, M. 2017. Routine invasive mediastinal staging of lung cancer in elderly patients without lymph adenopathy on PET-CT scan: is an appropriate choice?. JOURNAL OF GERONTOLOGY AND GERIATRICS. 65, 1 (Mar. 2017), 18-37.
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