Original articleGeneral thoracicRisk Factors for Occult Mediastinal Metastases in Clinical Stage I Non-Small Cell Lung Cancer
Section snippets
Material and Methods
We conducted a retrospective review of an institutional review board–approved prospective database to identify patients with potentially operable clinical stage I NSCLC with a CT-negative and PET-negative mediastinum from January 2000 to November 2006. This study was approved by the institutional review board of the Weill Medical College of Cornell University, and patient consent was waived. Patients were excluded if both PET and chest CT had not been performed. A total of 224 patients were
Clinical Findings
During the study period from January 2000 to November 2006, 224 patients (87 men, 137 women) were identified. Their median age was 69.5 years (range, 45 to 90 years). All patients were deemed to have clinical stage I NSCLC after radiologic assessments by CT of the chest and upper abdomen (including the adrenals), PET scanning, and any other appropriate imaging modalities including CT or magnetic resonance imaging of the brain. Cervical mediastinoscopies were done in 76 patients (34%), and 11
Comment
The diagnosis of bronchogenic carcinoma carries a dismal prognosis for most patients. The stage of carcinoma at diagnosis remains one of the most important determinants of survival in NSCLC, with earlier stage patients having a better chance of long-term survival [10]. For patients with resectable stage I disease, 5-year survival can be as high as 80% [11]. Patients with metastatic involvement of mediastinal lymph nodes have poor survival, however, and should not be offered surgical resection
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