Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan-Mar;105(1):368504221085152.
doi: 10.1177/00368504221085152.

Is extrathoracic metastasis screening necessary for clinical stage IA non-small cell lung cancer?

Yoshihito Iijima  1 , Masahito Ishikawa  1 , Shun Iwai  1 , Nozomu Motono  1 , Shigeki Yamagishi  2 , Kiyoshi Koizumi  2 , Hidetaka Uramoto  1
Affiliations

Is extrathoracic metastasis screening necessary for clinical stage IA non-small cell lung cancer?

Yoshihito Iijima et al. Sci Prog. 2022 Jan-Mar.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Early-stage; extrathoracic metastases; non-small cell lung cancer; preoperative; screening.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Patient selection flowchart.
Figure 2.
Figure 2.
Receiver operating characteristic (ROC) curve.
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin 2020; 70: 7–30. - PubMed
    1. Metintas M, Ak G, Akcayir IA, et al. Detecting extrathoracic metastases in patients with non-small cell lung cancer: is routine scanning necessary? Lung Cancer 2007; 58: 59–67. - PubMed
    1. Zhuge L, Huang Y, Wang S, et al. Preoperative brain MRI for clinical stage IA lung cancer: is routine scanning rational? J Cancer Res Clin Oncol 2019; 145: 503–509. - PMC - PubMed
    1. Ettinger DS, Wood DE, Aggarwal C, et al. NCCN Guidelines insights: non-small cell lung cancer, Version 1.2020. J Natl Compr Canc Netw 2019; 17: 1464–1472. - PubMed
    1. Lung cancer: diagnosis and management. London: National Institute for Health and Care Excellence (UK), 2019. - PubMed

MeSH terms