Ting Ye1, Lin Deng2, Shengping Wang3, Jiaqing Xiang1, Yawei Zhang1, Hong Hu1, Yihua Sun1, Yuan Li4, Lei Shen4, Li Xie5, Wenchao Gu6, Yue Zhao1, Fangqiu Fu1, Weijun Peng3, Haiquan Chen7. 1. Department of Thoracic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. 2. Department of Radiology, Shanghai Proton and Heavy Ion Center, Shanghai, People's Republic of China. 3. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Radiology, Shanghai Cancer Center, Fudan University, Shanghai, People's Republic of China. 4. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Pathology, Shanghai Cancer Center, Fudan University, Shanghai, People's Republic of China. 5. Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China. 6. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan. 7. Department of Thoracic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; School of Life Sciences, Fudan University, Shanghai, People's Republic of China; Institutes of Biomedical Sciences, Fudan University, Shanghai, China. Electronic address: hqchen1@yahoo.com.
Abstract
INTRODUCTION: The clinicopathologic features and prognostic predictors of radiological part-solid lung adenocarcinomas were unclear. METHODS: We retrospectively compared the clinicopathologic features and survival times of part-solid tumors with those of pure ground glass nodules (pGGNs) and pure solid tumors treated with surgery at Fudan University Shanghai Cancer Center and evaluated the prognostic implications of consolidation-to-tumor ratio (CTR), solid component size, and tumor size for part-solid lung adenocarcinomas. RESULTS: A total of 911 patients and 988 pulmonary nodules (including 329 part-solid nodules [PSNs], 501 pGGNs, and 158 pure solid nodules) were analyzed. More female patients (p = 0.015) and nonsmokers (p = 0.003) were seen with PSNs than with pure solid nodules. The prevalence of lymphatic metastasis was lower in patients with PSNs than in those with pure solid tumors (2.2% versus 27% [p < 0.001]). The 5-year lung cancer-specific (LCS) recurrence-free survival and LCS overall survival of patients with PSNs were worse than those of patients with pGGNs (p < 0.001 and p = .042, respectively) but better than those of patients with pure solid tumors ([p < 0.001 and p < 0.0001, respectively]). CTR (OR = 12.90; 95% confidence interval [CI]: 1.85-90.04), solid component size (OR = 1.45; 95% CI: 1.28-1.64), and tumor size (OR = 1.23; 95% CI: 1.15-1.31) could predict pathologic invasive adenocarcinoma for patients with PSNs. None of them could predict the prognosis. Patients receiving sublobar resection had prognoses comparable to those of patients receiving lobectomy (p = .178 for 5-year LCS recurrence-free survival and p = .319 for 5-year LCS overall survival). The prognostic differences between patients with systemic lymph node dissection and those without systemic lymph node dissection were statistically insignificant. CONCLUSIONS: Part-solid lung adenocarcinoma showed clinicopathologic features different from those of pure solid tumor. CTR, solid component size, and tumor size could not predict the prognosis. Part-solid lung adenocarcinomas define one special clinical subtype.
INTRODUCTION: The clinicopathologic features and prognostic predictors of radiological part-solid lung adenocarcinomas were unclear. METHODS: We retrospectively compared the clinicopathologic features and survival times of part-solid tumors with those of pure ground glass nodules (pGGNs) and pure solid tumors treated with surgery at Fudan University Shanghai Cancer Center and evaluated the prognostic implications of consolidation-to-tumor ratio (CTR), solid component size, and tumor size for part-solid lung adenocarcinomas. RESULTS: A total of 911 patients and 988 pulmonary nodules (including 329 part-solid nodules [PSNs], 501 pGGNs, and 158 pure solid nodules) were analyzed. More female patients (p = 0.015) and nonsmokers (p = 0.003) were seen with PSNs than with pure solid nodules. The prevalence of lymphatic metastasis was lower in patients with PSNs than in those with pure solid tumors (2.2% versus 27% [p < 0.001]). The 5-year lung cancer-specific (LCS) recurrence-free survival and LCS overall survival of patients with PSNs were worse than those of patients with pGGNs (p < 0.001 and p = .042, respectively) but better than those of patients with pure solid tumors ([p < 0.001 and p < 0.0001, respectively]). CTR (OR = 12.90; 95% confidence interval [CI]: 1.85-90.04), solid component size (OR = 1.45; 95% CI: 1.28-1.64), and tumor size (OR = 1.23; 95% CI: 1.15-1.31) could predict pathologic invasive adenocarcinoma for patients with PSNs. None of them could predict the prognosis. Patients receiving sublobar resection had prognoses comparable to those of patients receiving lobectomy (p = .178 for 5-year LCS recurrence-free survival and p = .319 for 5-year LCS overall survival). The prognostic differences between patients with systemic lymph node dissection and those without systemic lymph node dissection were statistically insignificant. CONCLUSIONS: Part-solid lung adenocarcinoma showed clinicopathologic features different from those of pure solid tumor. CTR, solid component size, and tumor size could not predict the prognosis. Part-solid lung adenocarcinomas define one special clinical subtype.
Authors: Qingpeng Zeng; Bingzhi Wang; Jiagen Li; Jun Zhao; Yousheng Mao; Yushun Gao; Qi Xue; Shugeng Gao; Nan Sun; Jie He Journal: Cancer Manag Res Date: 2020-09-08 Impact factor: 3.989
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