Implication of total tumor size on the prognosis of patients with clinical stage IA lung adenocarcinomas appearing as part-solid nodules: Does only the solid portion size matter?
Objectives: The aim was to investigate the effect of clinico-radiologic variables, including total tumor (Ttotal) size and clinical T category, on the prognosis of patients with stage IA (T1N0M0) lung adenocarcinomas appearing as part-solid nodules (PSNs).Methods: This institutional review board-app...
| Publicado en: | European Radiology Vol. 29; no. 3; pp. 1586 - 1595 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=134415309&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 134415309 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Mar2019 vid: 29 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 134415309 134415309 NLM30132107 134415309 10.1007/s00330-018-5685-7 NLM30132107 134415309 ppf: 1586 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Implication of total tumor size on the prognosis of patients with clinical stage IA lung adenocarcinomas appearing as part-solid nodules: Does only the solid portion size matter? aug: au: Kim, Hyungjin Goo, Jin Mo Suh, Young Joo Park, Chang Min Kim, Young Tae affil: Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Korea sug: subj: Lung Neoplasms Pathology Body Weights and Measures Neoplasm Metastasis Prognosis Lung Neoplasms Aged Neoplasm Recurrence, Local Female Retrospective Design Middle Age Lymph Nodes Pathology Male Cox Proportional Hazards Model Tomography, X-Ray Computed Risk Factors Neoplasm Staging Human Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Objectives: The aim was to investigate the effect of clinico-radiologic variables, including total tumor (Ttotal) size and clinical T category, on the prognosis of patients with stage IA (T1N0M0) lung adenocarcinomas appearing as part-solid nodules (PSNs).Methods: This institutional review board-approved retrospective study included 506 patients (male:female = 200:306; median age, 62 years) with PSNs of the adenocarcinoma spectrum in clinical stage IA who underwent standard lobectomy at a single tertiary medical center. Prognostic stratification of the patients in terms of disease-free survival was analyzed with variables including age, sex, Ttotal size, solid portion size, clinical T category, and tumor location using univariate and subsequent multivariate Cox regression analysis. Subgroup analysis was performed to reveal the effect of the Ttotal size at each clinical T category.Results: Multivariate Cox regression analysis demonstrated that Ttotal size*cT1b [interaction term; hazard ratio (HR) = 1.091; 95% confidence interval (CI): 1.015, 1.173; p = 0.019] and cT1c (HR = 68.436; 95% CI: 2.797, 1674.415; p = 0.010) were independent risk factors for the tumor recurrence. When patients with cT1b were dichotomized based on a Ttotal size cutoff of 3.0 cm, PSNs with Ttotal > 3.0 cm showed a significantly worse outcome (HR = 3.796; 95% CI: 1.006, 14.317; p = 0.049). No significant difference was observed in the probability of recurrence between cT1b with Ttotal > 3.0 cm and cT1c (p = 0.915).Conclusions: Ttotal size is a significant prognostic factor in adenocarcinoma patients in cT1b without lymph node or distant metastasis. PSNs in cT1b with Ttotal > 3.0 cm have a comparable risk of lung cancer recurrence to those in cT1c.Key Points: • Current T descriptor was a powerful prognostic factor in stage IA adenocarcinomas appearing as part-solid nodules. • Total tumor size further stratified risk of recurrence of adenocarcinomas in cT1b. • Upstaging of tumors in cT1b with total tumor size > 3.0 cm may be more appropriate. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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