Aritoshi Hattori1, Takeshi Matsunaga1, Kazuya Takamochi1, Shiaki Oh1, Kenji Suzuki2. 1. Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan. 2. Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: kjsuzuki@juntendo.ac.jp.
Abstract
BACKGROUND: We aimed to investigate the prognostic impact of tumor size based on the consolidation status by thin-section computed tomography. METHODS: We evaluated 1,181 surgically resected clinical N0 M0 non-small cell lung carcinomas. Consolidation tumor ratio (CTR) was evaluated for all, and tumors were classified into three groups, namely pure ground-glass opacity (CTR = 0; n = 168), part-solid (0 < CTR < 1.0; n = 448), and solid (CTR = 1.0; n = 565). The impact of tumor size was assessed based on CTR using Cox proportional hazards model. RESULTS: Tumor size significantly differentiated the 5-year overall survival (≤20 mm; n = 638: 93.4%; 21-30 mm; n = 284: 84.2%; 31-50 mm; n = 193: 69.3%; ≥51 mm; n = 66: 43.5%; p < 0.0001). When we evaluated the impact of tumor size based on CTR, the 5-year overall survival differed significantly in patients with radiologic solid lung cancer (≤20 mm: 83.0%; 21-30 mm: 75.4%; 31-50 mm: 56.2%; ≥51 mm: 45.3%; p < 0.0001). In contrast, it did not affect the 5-year overall survival in patients with radiologic pure ground-glass opacity (100% regardless of the tumor sizes) and part-solid lung cancer (≤20 mm: 97.7%; 21-30 mm: 94.6%; 31-50 mm: 93.4%; p = 0.1028; 0 < CTR ≤ 0.5: 98.4%; 0.5 < CTR < 1.0: 95.0%; p = 0.1247). Furthermore, maximum tumor size (p = 0.6370), solid component size (p = 0.2340), and CTR (p = 0.1395) were not associated with poor overall survival in radiologic part-solid lung cancer. CONCLUSIONS: The impact of maximum tumor size should be applied only to radiologic solid lung cancer without the ground-glass opacity component on thin-section computed tomography. On the other hand, we recommend that pure ground-glass opacity and part-solid lung cancers be described, respectively, as clinical-Tis and clinical-T1a, which are independent of maximum tumor size and solid component size on thin-section computed tomography.
BACKGROUND: We aimed to investigate the prognostic impact of tumor size based on the consolidation status by thin-section computed tomography. METHODS: We evaluated 1,181 surgically resected clinical N0 M0 non-small cell lung carcinomas. Consolidation tumor ratio (CTR) was evaluated for all, and tumors were classified into three groups, namely pure ground-glass opacity (CTR = 0; n = 168), part-solid (0 < CTR < 1.0; n = 448), and solid (CTR = 1.0; n = 565). The impact of tumor size was assessed based on CTR using Cox proportional hazards model. RESULTS:Tumor size significantly differentiated the 5-year overall survival (≤20 mm; n = 638: 93.4%; 21-30 mm; n = 284: 84.2%; 31-50 mm; n = 193: 69.3%; ≥51 mm; n = 66: 43.5%; p < 0.0001). When we evaluated the impact of tumor size based on CTR, the 5-year overall survival differed significantly in patients with radiologic solid lung cancer (≤20 mm: 83.0%; 21-30 mm: 75.4%; 31-50 mm: 56.2%; ≥51 mm: 45.3%; p < 0.0001). In contrast, it did not affect the 5-year overall survival in patients with radiologic pure ground-glass opacity (100% regardless of the tumor sizes) and part-solid lung cancer (≤20 mm: 97.7%; 21-30 mm: 94.6%; 31-50 mm: 93.4%; p = 0.1028; 0 < CTR ≤ 0.5: 98.4%; 0.5 < CTR < 1.0: 95.0%; p = 0.1247). Furthermore, maximum tumor size (p = 0.6370), solid component size (p = 0.2340), and CTR (p = 0.1395) were not associated with poor overall survival in radiologic part-solid lung cancer. CONCLUSIONS: The impact of maximum tumor size should be applied only to radiologic solid lung cancer without the ground-glass opacity component on thin-section computed tomography. On the other hand, we recommend that pure ground-glass opacity and part-solid lung cancers be described, respectively, as clinical-Tis and clinical-T1a, which are independent of maximum tumor size and solid component size on thin-section computed tomography.