Keiju Aokage1, Tomohiro Miyoshi2, Genichiro Ishii3, Masahiro Kusumoto4, Shogo Nomura5, Shinya Katsumata2, Keigo Sekihara2, Tomoyuki Hishida2, Masahiro Tsuboi2. 1. Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan. Electronic address: kaokage@east.ncc.go.jp. 2. Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan. 3. Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Chiba, Japan. 4. Department of Diagnostic Radiology, National Cancer Center Hospital East, Chiba, Japan. 5. Biostatistics Division Center for Research Administration and Support, National Cancer Center, Chiba, Japan.
Abstract
INTRODUCTION: The aim of this study was to validate the new eighth edition of the TNM classification and to elucidate whether radiological solid size corresponds to pathological invasive size incorporated in this T factor. METHODS: We analyzed the data on 1792 patients who underwent complete resection from 2003 to 2011 at the National Cancer Center Hospital East, Japan. We reevaluated preoperative thin-section computed tomography (TSCT) to determine solid size and pathological invasive size using the fourth edition of the WHO classification and reclassified them according to the new TNM classification. The discriminative power of survival curves by the seventh edition was compared with that by the eighth edition by using concordance probability estimates and Akaike's information criteria calculated using a univariable Cox regression model. Pearson's correlation coefficient was calculated to elucidate the correlation between radiological solid size using TSCT and pathological invasive size. RESULTS: The overall survival curves in the eighth edition were well distinct at each clinical and pathological stage. The 5-year survival rates of patients with clinical and pathological stage 0 newly defined were both 100%. The concordance probability estimate and Akaike's information criterion values of the eighth edition were higher than those of the seventh edition in discriminatory power for overall survival. Solid size on TSCT scan and pathological invasive size showed a positive linear relationship, and Pearson's correlation coefficient was calculated as 0.83, which indicated strong correlation. CONCLUSIONS: This TNM classification will be feasible regarding patient survival, and radiological solid size correlates significantly with pathological invasive size as a new T factor.
INTRODUCTION: The aim of this study was to validate the new eighth edition of the TNM classification and to elucidate whether radiological solid size corresponds to pathological invasive size incorporated in this T factor. METHODS: We analyzed the data on 1792 patients who underwent complete resection from 2003 to 2011 at the National Cancer Center Hospital East, Japan. We reevaluated preoperative thin-section computed tomography (TSCT) to determine solid size and pathological invasive size using the fourth edition of the WHO classification and reclassified them according to the new TNM classification. The discriminative power of survival curves by the seventh edition was compared with that by the eighth edition by using concordance probability estimates and Akaike's information criteria calculated using a univariable Cox regression model. Pearson's correlation coefficient was calculated to elucidate the correlation between radiological solid size using TSCT and pathological invasive size. RESULTS: The overall survival curves in the eighth edition were well distinct at each clinical and pathological stage. The 5-year survival rates of patients with clinical and pathological stage 0 newly defined were both 100%. The concordance probability estimate and Akaike's information criterion values of the eighth edition were higher than those of the seventh edition in discriminatory power for overall survival. Solid size on TSCT scan and pathological invasive size showed a positive linear relationship, and Pearson's correlation coefficient was calculated as 0.83, which indicated strong correlation. CONCLUSIONS: This TNM classification will be feasible regarding patient survival, and radiological solid size correlates significantly with pathological invasive size as a new T factor.
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Authors: Dong Jin Im; Sang Min Lee; Kyunghwa Han; Chul Hwan Park; Ji Won Lee; Sung Ho Hwang; Jae Seung Seo; Woocheol Kwon; Kye Ho Lee; Jin Hur Journal: Thorac Cancer Date: 2021-02-07 Impact factor: 3.500