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@ARTICLE{Okumus:186691,
      author       = {Ö. Okumus and K. Mardanzai and T. Plönes and D.
                      Theegarten and K. Darwiche and M. Schuler$^*$ and F. Nensa
                      and H. Hautzel and K. Hermann and M. Stuschke$^*$ and B.
                      Hegedus and C. Aigner},
      title        = {{P}reoperative {PET}-{SUV}max and volume based {PET}
                      parameters of the primary tumor fail to predict nodal
                      upstaging in early-stage lung cancer.},
      journal      = {Lung cancer},
      volume       = {176},
      issn         = {0169-5002},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2023-00060},
      pages        = {82 - 88},
      year         = {2023},
      abstract     = {Accurate nodal staging is of utmost importance in patients
                      with lung cancer. FDG-PET/CT imaging is now part of the
                      routine staging. Despite thorough preoperative staging nodal
                      upstaging still occurs in early-stage lung cancer. However,
                      the predictive value of preoperative PET metrics of the
                      primary tumor on nodal upstaging remains to be unexplored.
                      Our aim was to assess the association of these preoperative
                      PET-parameters with nodal upstaging in histologically
                      confirmed lung adenocarcinoma and squamous cell
                      carcinoma.From January 2016 to November 2018, 500 patients
                      with pT1-T2/cN0 lung cancer received an anatomical resection
                      with curative intent. 171 patients with adenocarcinoma and
                      squamous cell carcinoma and available PET-CTs were
                      retrospectively included. We analyzed the the association of
                      nodal upstaging with preoperative PET-SUVmax and metabolic
                      PET metrics including total lesion glycolysis (TLG) and
                      metabolic tumor volume (MTV) with different defined
                      thresholds.High values of preoperative PET-SUVmax of the
                      primary tumor were associated with squamous cell carcinoma
                      (p < 0.0001) and with larger tumors (p < 0.0001). Increased
                      preoperative C-reactive protein levels (<1mg/dL) correlated
                      significantly with high preoperative PET-SUVmax values (p <
                      0.0001). No significant relationship between PET-SUVmax and
                      lactate dehydrogenase activity (p = 0.6818), white blood
                      cell count (p = 0.7681), gender (p = 0.1115) or age (p =
                      0.9284) was observed. Nodal upstaging rate was 14.0 $\%$
                      with 8.8 $\%$ N1 and 5.3 $\%$ N2 upstaging. Tumor size (p =
                      0.0468) and number of removed lymph nodes (p = 0.0461) were
                      significant predictors of nodal upstaging but no significant
                      association was found with histology or PET parameters. Of
                      note, increased MTV - regardless of the threshold - tended
                      to associate with nodal upstaging.Early-stage lung cancer
                      patients with squamous histology and T2 tumors presented
                      increased preoperative PET-SUVmax values. Nevertheless,
                      beyond tumor size and number of removed lymph nodes neither
                      SUVmax nor metabolic PET parameters MTV and TLG were
                      significant predictors of nodal upstaging.},
      keywords     = {CRP (Other) / Lung cancer (Other) / MTV (Other) / Nodal
                      upstaging (Other) / PET-SUVmax (Other) / TLG (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36623341},
      doi          = {10.1016/j.lungcan.2022.12.013},
      url          = {https://inrepo02.dkfz.de/record/186691},
}