Mamoru Takahashi1, Yoshiki Shigematsu2, Makoto Ohta3, Hironobu Tokumasu4, Tadashi Matsukura2, Takashi Hirai2. 1. Department of Chest Surgery, Fukui Red Cross Hospital, Fukui, Japan. Electronic address: mt10947@yahoo.co.jp. 2. Department of Chest Surgery, Fukui Red Cross Hospital, Fukui, Japan. 3. Department of Pathology, Fukui Red Cross Hospital, Fukui, Japan. 4. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Abstract
OBJECTIVES: The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) have collaborated to propose a new pathologic classification of lung adenocarcinoma. In this classification, noninvasiveness and invasiveness have been newly defined for lung adenocarcinoma. The aims of this study were to validate the prognostic significance of tumor invasiveness as defined by the new IASLC/ATS/ERS classification and to assess the relationship between pathologic invasiveness and radiologic findings in pathologic stage IA lung adenocarcinoma. METHODS: We retrospectively reviewed 123 consecutive patients with pathologic stage IA lung adenocarcinoma. Pathologic data were classified according to the new IASLC/ATS/ERS classification. The following radiologic parameters were assessed using thin-section computed tomography: the ground-glass opacity ratio, tumor disappearance rate, and consolidation diameter. RESULTS: There were 54 noninvasive and 69 invasive adenocarcinomas. Five-year overall survival rates for noninvasive adenocarcinoma and invasive adenocarcinoma were 100% and 78.4%, respectively; this difference was statistically significant (P < .01), indicating the prognostic value of this classification. Receiver operating characteristic curves of the ground-glass opacity ratio, tumor disappearance rate, and consolidation diameter identified the optimal cut-off values for predicting the presence of invasive tumors as 50%, 75%, and 10 mm, respectively. CONCLUSIONS: We found that by using the new IASLC/ATS/ERS classification, histologic subtypes of pathologic stage IA lung adenocarcinoma with prognostic value could be identified. Tumor invasiveness of lung adenocarcinoma as defined by this classification can be predicted by evaluating the ground-glass opacity ratio, tumor disappearance rate, and consolidation diameter on thin-section computed tomography.
OBJECTIVES: The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) have collaborated to propose a new pathologic classification of lung adenocarcinoma. In this classification, noninvasiveness and invasiveness have been newly defined for lung adenocarcinoma. The aims of this study were to validate the prognostic significance of tumor invasiveness as defined by the new IASLC/ATS/ERS classification and to assess the relationship between pathologic invasiveness and radiologic findings in pathologic stage IA lung adenocarcinoma. METHODS: We retrospectively reviewed 123 consecutive patients with pathologic stage IA lung adenocarcinoma. Pathologic data were classified according to the new IASLC/ATS/ERS classification. The following radiologic parameters were assessed using thin-section computed tomography: the ground-glass opacity ratio, tumor disappearance rate, and consolidation diameter. RESULTS: There were 54 noninvasive and 69 invasive adenocarcinomas. Five-year overall survival rates for noninvasive adenocarcinoma and invasive adenocarcinoma were 100% and 78.4%, respectively; this difference was statistically significant (P < .01), indicating the prognostic value of this classification. Receiver operating characteristic curves of the ground-glass opacity ratio, tumor disappearance rate, and consolidation diameter identified the optimal cut-off values for predicting the presence of invasive tumors as 50%, 75%, and 10 mm, respectively. CONCLUSIONS: We found that by using the new IASLC/ATS/ERS classification, histologic subtypes of pathologic stage IA lung adenocarcinoma with prognostic value could be identified. Tumor invasiveness of lung adenocarcinoma as defined by this classification can be predicted by evaluating the ground-glass opacity ratio, tumor disappearance rate, and consolidation diameter on thin-section computed tomography.
Keywords:
10.2; 36.1; AIS; AUC; BAC; CD; CEA; CT; GGO; HU; Hounsfield unit; IASLC/ATS/ERS; International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society; MIA; ROC; TDR; adenocarcinoma in situ; area under the curve; bronchioloalveolar carcinoma; carcinoembryonic antigen; computed tomography; consolidation diameter; ground-glass opacity; minimally invasive adenocarcinoma; p-stage IA; pathologic stage IA; receiver operating characteristic; tumor disappearance rate
Authors: Yi-Chen Yeh; Kyuichi Kadota; Jun-ichi Nitadori; Camelia S Sima; Nabil P Rizk; David R Jones; William D Travis; Prasad S Adusumilli Journal: Eur J Cardiothorac Surg Date: 2015-09-15 Impact factor: 4.191