A Pragmatic Approach to the Diagnosis of Nodal Micrometastases in Early Stage Non- small Cell Lung Cancer Esther Herpel, MD, Thomas Muley, PhD, Thomas.

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Presentation transcript:

A Pragmatic Approach to the Diagnosis of Nodal Micrometastases in Early Stage Non- small Cell Lung Cancer Esther Herpel, MD, Thomas Muley, PhD, Thomas Schneider, MD, Elisa Palm, MD, Dörthe Kieslich de Hol, PhD student, Arne Warth, MD, Michael Meister, PhD, Konstantina Storz, MD, Philipp A. Schnabel, MD, PhD, Peter Schirmacher, MD, PhD, Hendrik Dienemann, MD, PhD, Hans Hoffmann, MD, PhD Journal of Thoracic Oncology Volume 5, Issue 8, Pages 1206-1212 (August 2010) DOI: 10.1097/JTO.0b013e3181e15cfd Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Disease-free survival of patients staged by standard histopathologic workup (stage I: blue line, stage II: green line). Journal of Thoracic Oncology 2010 5, 1206-1212DOI: (10.1097/JTO.0b013e3181e15cfd) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Disease-free survival (DFS) of patients restaged (upstaged) according to detection of nodal micrometastases after extended workup: patients with micrometastases in N2-lymph nodes (red line) had a statistically significant (p = 0.022) shorter mean DFS as compared with N0/1 patients. DFS of patients with negative nodes (blue line) and of patients with micrometastases in N1-lymph nodes (green line) was not statistically significant (p = 0.537) different. Journal of Thoracic Oncology 2010 5, 1206-1212DOI: (10.1097/JTO.0b013e3181e15cfd) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Overall survival (OS) of patients restaged (upstaged) according to detection of nodal micrometastases after extended workup: patients with micrometastases in N2-lymph nodes (red line) had a statistically significant (p = 0.001) shorter mean OS as compared to N0 patients. OS of patients with negative nodes (blue line) and of patients with micrometastases in N1-lymph nodes (green line) was not statistically significant (p = 0.191) different. Journal of Thoracic Oncology 2010 5, 1206-1212DOI: (10.1097/JTO.0b013e3181e15cfd) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 Suggested algorithm for an extended histopathologic workup aimed at detection of nodal micrometastases in resected stage I/II NSCLC. NSCLC, non-small cell lung cancer. Journal of Thoracic Oncology 2010 5, 1206-1212DOI: (10.1097/JTO.0b013e3181e15cfd) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions