Keiju Aokage1, Tomohiro Miyoshi2, Genichiro Ishii3, Masahiro Kusumoto4, Shogo Nomura5, Shinya Katsumata2, Keigo Sekihara2, Kenta Tane2, Masahiro Tsuboi2. 1. Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan. Electronic address: kaokage@east.ncc.go.jp. 2. Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan. 3. Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Kashiwa, Japan. 4. Department of Diagnostic Radiology, National Cancer Center Hospital East, Kashiwa, Japan. 5. Biostatistics Division Center for Research Administration and Support, National Cancer Center, Kashiwa, Japan.
Abstract
INTRODUCTION: The aim was to clarify the influence on patient prognosis of ground glass opacity (GGO) component in each new TNM stage and propose grouping reflecting the prognosis more accurately. METHODS: We examined the data on 1290 patients who underwent lung cancer resection from 2003 to 2011. The demographics and overall survival of patients with adenocarcinoma with and without GGO, squamous cell carcinoma, and the others were compared according to clinical stage from 0 to IB. In adenocarcinoma, we examined the distribution of histological subtypes of adenocarcinoma with and without GGO in each clinical stage. RESULTS: Each clinical stage differentiated overall survival well. However, the prognosis of the patients with adenocarcinoma with GGO was considerably more favorable than that of the others in clinical stage IA2 and IA3 but not of those in clinical stage IB. In clinical stage 0 to IA3, patients showing adenocarcinoma in situ, minimally invasive adenocarcinoma, and invasive lepidic predominant adenocarcinoma accounted for about 50% of the total number of patients with adenocarcinoma with GGO (stage 0, 16 of 21; stage IA1, 113 of 143; stage IA2, 80 of 157; and stage IA3, 45 of 94). In clinical stage IB, 20% of adenocarcinomas with GGO showed invasive solid predominant adenocarcinoma (IB, seven of 38). Most of the adenocarcinomas without GGO were in clinical stage IA2 to IB, and the distribution of histological subtypes was similar at each clinical stage. Invasive acinar and solid predominant adenocarcinomas were more common in adenocarcinoma without GGO. CONCLUSIONS: Clinical T classification considering GGO component may offer more accurate prognosis for patients with lung cancer less than 3 cm in invasive diameter.
INTRODUCTION: The aim was to clarify the influence on patient prognosis of ground glass opacity (GGO) component in each new TNM stage and propose grouping reflecting the prognosis more accurately. METHODS: We examined the data on 1290 patients who underwent lung cancer resection from 2003 to 2011. The demographics and overall survival of patients with adenocarcinoma with and without GGO, squamous cell carcinoma, and the others were compared according to clinical stage from 0 to IB. In adenocarcinoma, we examined the distribution of histological subtypes of adenocarcinoma with and without GGO in each clinical stage. RESULTS: Each clinical stage differentiated overall survival well. However, the prognosis of the patients with adenocarcinoma with GGO was considerably more favorable than that of the others in clinical stage IA2 and IA3 but not of those in clinical stage IB. In clinical stage 0 to IA3, patients showing adenocarcinoma in situ, minimally invasive adenocarcinoma, and invasive lepidic predominant adenocarcinoma accounted for about 50% of the total number of patients with adenocarcinoma with GGO (stage 0, 16 of 21; stage IA1, 113 of 143; stage IA2, 80 of 157; and stage IA3, 45 of 94). In clinical stage IB, 20% of adenocarcinomas with GGO showed invasive solid predominant adenocarcinoma (IB, seven of 38). Most of the adenocarcinomas without GGO were in clinical stage IA2 to IB, and the distribution of histological subtypes was similar at each clinical stage. Invasive acinar and solid predominant adenocarcinomas were more common in adenocarcinoma without GGO. CONCLUSIONS: Clinical T classification considering GGO component may offer more accurate prognosis for patients with lung cancer less than 3 cm in invasive diameter.
Authors: Chengdi Wang; Yuxuan Wu; Jingwei Li; Pengwei Ren; Ya Gou; Jun Shao; Yaojie Zhou; Xue Xiao; Paierhati Tuersun; Dan Liu; Li Zhang; Weimin Li Journal: Ann Transl Med Date: 2020-09