Department of Thoracic Surgery, 12857Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan.
Department of Thoracic Surgery, 38055Aidu Chuo Hospital, Aizuwakamatsu, Fukushima, Japan.
Sci Prog. 2022 Jan-Mar;105(1):368504221085152. doi: 10.1177/00368504221085152.
Detecting distant metastases when staging lung cancer is critical to avoid unnecessary surgery and provide appropriate multidisciplinary treatment. However, it is controversial as to whether staging studies should be performed routinely for patients with early-stage lung cancer who have no evidence of distant metastasis. Thus, this study aimed to examine the need for extrathoracic metastasis screening in patients with clinical stage IA non-small cell lung cancer, understand the association between extrathoracic metastasis and other clinical features, and evaluate the diagnostic efficiency of imaging screening for preoperative extrathoracic metastasis in patients with early-stage lung cancer.
From 2010 to 2019, 510 patients diagnosed with clinical T1N0 lung cancer, excluding contralateral lung metastases, pleural dissemination, malignant pleural effusion, and malignant pericardial effusion, were treated for primary lung cancer. Patients were divided into two groups, and their clinicopathological characteristics were investigated.
Five patients (1.0%) had extrathoracic metastases. The histological types were adenocarcinoma in three of the cases, and squamous cell carcinoma and large cell neuroendocrine carcinoma in the other two cases. The T factor was T1b in one case and T1c in four cases. Four patients had solid tumors and one had a solid predominant tumor with an average tumor diameter of 23.0 ± 2.9 mm. The size of solid tumors with extrathoracic metastases was larger than their counterparts.
When evaluating stage IA non-small cell lung cancer with a solid component diameter < 22 mm, or clinical T1mi-1bN0 in computed tomography evaluation, screening for preoperative extrathoracic metastasis may be omitted.
在分期肺癌时检测远处转移对于避免不必要的手术和提供适当的多学科治疗至关重要。然而，对于没有远处转移证据的早期肺癌患者是否应该常规进行分期研究仍存在争议。因此，本研究旨在检查临床ⅠA 期非小细胞肺癌患者是否需要进行胸外转移筛查，了解胸外转移与其他临床特征之间的关系，并评估影像学筛查对早期肺癌患者术前胸外转移的诊断效率。
2010 年至 2019 年，510 例临床 T1N0 肺癌患者（不包括对侧肺转移、胸膜播散、恶性胸腔积液和恶性心包积液）接受了原发性肺癌治疗。患者分为两组，并对其临床病理特征进行了调查。
5 例（1.0%）患者存在胸外转移。组织学类型为 3 例腺癌，2 例鳞癌和 2 例大细胞神经内分泌癌。T 因子在 1 例为 T1b，4 例为 T1c。4 例为实体瘤，1 例为实性为主的肿瘤，平均肿瘤直径为 23.0±2.9 mm。伴有胸外转移的实体瘤的大小大于无转移的肿瘤。
在评估直径＜22 mm 的实性成分的ⅠA 期非小细胞肺癌或 CT 评估的临床 T1mi-1bN0 时，可能可以省略术前胸外转移的筛查。
