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European Radiology
Published in: European Radiology 12/2017

01-12-2017 | Chest

The relationship of cancer characteristics and patient outcome with time to lung cancer diagnosis after an abnormal screening CT

Authors: Sushilkumar K. Sonavane, Paul Pinsky, Jubal Watts Jr, David S. Gierada, Reginald Munden, Satinder P. Singh, Hrudaya Nath

Published in: European Radiology | Issue 12/2017

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Abstract

Purpose

The National Lung Screening Trial (NLST) demonstrated a reduction in lung cancer and all-cause mortality with low-dose CT (LDCT) screening. The aim of our study was to examine the time to diagnosis (TTD) of lung cancer in the LDCT arm of the NLST and assess its relationship with cancer characteristics and survival.

Methods

The subjects (N = 462) with a positive baseline screen and subsequent lung cancer diagnosis within 3 years were evaluated by data and image review to confirm the baseline abnormality. The cases were analysed for the relationship between TTD and imaging features, cancer type, stage and survival for 7 years from baseline screen.

Results

Cancer was judged to be present at baseline in 397/462 cases. The factors that showed significant association (p value trend less than 0.05) with longer TTD included smaller nodule size, pure ground glass nodules (GGNs), smooth/lobulated margins, stages I/II, adenocarcinoma, and decreasing lung cancer mortality. The logistic regression model for lung cancer death showed significant inverse relationships with size less than 20 mm (OR = 0.32), pure GGNs (OR = 0.24), adenocarcinoma (OR = 0.57) and direct relationship with age (OR = 1.4).

Conclusion

TTD after a positive LDCT screen in the NLST showed a strong association with imaging features, stage and mortality.

Key Points

• NLST observed variable time to lung cancer diagnosis from positive baseline screen.
• Time to diagnosis was associated with imaging features, cancer type and stage.
• In univariate but not multivariate analysis, longer TTD correlated with decreased mortality.
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Metadata
Title
The relationship of cancer characteristics and patient outcome with time to lung cancer diagnosis after an abnormal screening CT
Authors
Sushilkumar K. Sonavane
Paul Pinsky
Jubal Watts Jr
David S. Gierada
Reginald Munden
Satinder P. Singh
Hrudaya Nath
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4886-9

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