Routine invasive mediastinal staging of lung cancer in elderly patients without lymph adenopathy on PET-CT scan: is an appropriate choice?
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.
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© Società Italiana di Gerontologia e Geriatria (SIGG) , 2017
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