{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:02:58Z","timestamp":1777363378932,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,7,25]],"date-time":"2016-07-25T00:00:00Z","timestamp":1469404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,7,25]],"date-time":"2016-07-25T00:00:00Z","timestamp":1469404800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lymph nodes in patients with non\u2010small cell lung cancer (NSCLC) are often staged using integrated 18F\u2010fluorodeoxyglucose positron emission tomography\/computed tomography (FDG\u2010PET\/CT). However, this modality has limited ability to detect micrometastases. We aimed to define risk factors for occult lymph node metastasis in patients with clinical stage I NSCLC diagnosed by preoperative integrated FDG\u2010PET\/CT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the records of 246 patients diagnosed with clinical stage I NSCLC based on integrated FDG\u2010PET\/CT between April 2007 and May 2015. All patients were treated by complete surgical resection. The prevalence of occult lymph node metastasis in patients with clinical stage I NSCLC was analysed according to clinicopathological factors. Risk factors for occult lymph node metastasis were defined using univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Occult lymph node metastasis was detected in 31 patients (12.6 %). Univariate analysis revealed CEA (<jats:italic>P<\/jats:italic> = 0.04), SUV<jats:sub>max<\/jats:sub> of the primary tumour (<jats:italic>P<\/jats:italic> = 0.031), adenocarcinoma (<jats:italic>P<\/jats:italic> = 0.023), tumour size (<jats:italic>P<\/jats:italic> = 0.002) and pleural invasion (<jats:italic>P<\/jats:italic> = 0.046) as significant predictors of occult lymph node metastasis. Multivariate analysis selected SUV<jats:sub>max<\/jats:sub> of the primary tumour (<jats:italic>P<\/jats:italic> = 0.049), adenocarcinoma (<jats:italic>P<\/jats:italic> = 0.003) and tumour size (<jats:italic>P<\/jats:italic> = 0.019) as independent predictors of occult lymph node metastasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The SUV<jats:sub>max<\/jats:sub> of the primary tumour, adenocarcinoma and tumour size were risk factors for occult lymph node metastasis in patients with NSCLC diagnosed as clinical stage I by preoperative integrated FDG\u2010PET\/CT. These findings would be helpful in selecting candidates for mediastinoscopy or endobronchial ultrasound\u2010guided transbronchial needle aspiration.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3652-5","type":"journal-article","created":{"date-parts":[[2016,7,25]],"date-time":"2016-07-25T19:44:30Z","timestamp":1469475870000},"page":"2976-2983","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Risk Factors for Predicting Occult Lymph Node Metastasis in Patients with Clinical Stage I Non\u2010small Cell Lung Cancer Staged by Integrated Fluorodeoxyglucose Positron Emission Tomography\/Computed Tomography"],"prefix":"10.1002","volume":"40","author":[{"given":"Kaoru","family":"Kaseda","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Sagamihara Kyodo Hospital 2\u20108\u201018 Hashimoto, Midori\u2010ku 252\u20105188 Sagamihara Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Asakura","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Sagamihara Kyodo Hospital 2\u20108\u201018 Hashimoto, Midori\u2010ku 252\u20105188 Sagamihara Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Kazama","sequence":"additional","affiliation":[{"name":"Department of Pathology Sagamihara Kyodo Hospital Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiko","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Yuai Clinic Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,7,25]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.57.1.43"},{"key":"e_1_2_8_3_2","first-page":"119","article-title":"Mediastinal lymph node evaluation by computed tomographic scan in lung cancer","volume":"42","author":"Kamiyoshihara M","year":"2001","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2312021185"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.02.067"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022136"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.09.026"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.06.041"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.1_suppl.137S"},{"key":"e_1_2_8_10_2","volume-title":"Histological typing of lung and pleural tumours","author":"World Health Organization","year":"2004"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31812f3c1a"},{"key":"e_1_2_8_12_2","first-page":"83","article-title":"Performance characteristics of a new 3\u2010dimensional continuous\u2010emission and spiral\u2010transmission high\u2010sensitivity and high\u2010resolution PET camera evaluated with the NEMA NU 2\u20102001 standard","volume":"47","author":"Matsumoto K","year":"2006","journal-title":"J Nucl Med"},{"key":"e_1_2_8_13_2","unstructured":"KitamuraK IshikawaA MizutaTet al (2004)3D continuous emission and spiral transmission scanning for high\u2010throughput whole\u2010body PET. 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