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01-12-2015 | Thoracic Oncology

Diameter of Solid Tumor Component Alone Should be Used to Establish T Stage in Lung Adenocarcinoma

Authors: Bryan M. Burt, MD, Ann N. Leung, MD, Masahiro Yanagawa, MD, William Chen, MD, Shawn S. Groth, MD, Chuong D. Hoang, MD, Viswam S. Nair, MD, Joseph B. Shrager, MD

Published in: Annals of Surgical Oncology | Special Issue 3/2015

Abstract

Purpose

The computed tomographic (CT) appearance of so-called ground glass components within lung adenocarcinomas correlate with noninvasive tumor histology, and solid radiographic components correlate with invasive histology. We hypothesized that T stage might be more accurately applied by considering the solid component nodule diameter rather than total nodule diameter.

Methods

We identified 74 patients with a solitary lung adenocarcinoma who underwent resection without receiving neoadjuvant therapy. Maximum total diameter and solid diameter of the nodules were measured on CT scans performed within 3 months of surgery. Cox proportional hazard modeling and Kaplan–Meier analyses were performed to determine whether total nodule diameter or solid component diameter was more predictive of overall survival.

Results

Thirty-three patients (45 %) had a solid nodule and 41 patients (55 %) had a part-solid nodule. Most patients were white (59 %) and female (69 %), and 42 % had never smoked. Seventy-four percent underwent lobectomy and 23 % sublobar resection. Sixty-six percent had pathologic stage I disease, 22 % stage II, and 12 % stage IIIA. Mean ± SD total and solid nodule diameters were 32.1 ± 17.5 and 24.8 ± 18.0 mm, respectively (p = 0.01). Among patients with part-solid nodules, multivariate modeling incorporating significant univariate predictors of survival (age, gender, procedure, N descriptor) revealed that maximum solid diameter was associated with overall survival (hazard ratio 1.4, p = 0.01), while maximum total diameter was not.

Conclusions

In a largely non-Asian cohort undergoing resection for adenocarcinoma, radiographic diameter of the solid component of a part-solid lesion on CT predicts overall survival better than total lesion diameter. These data provide further evidence to support altering the T descriptor for lung adenocarcinoma for part-solid nodules.

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Title: Diameter of Solid Tumor Component Alone Should be Used to Establish T Stage in Lung Adenocarcinoma
Authors: Bryan M. Burt, MD
Ann N. Leung, MD
Masahiro Yanagawa, MD
William Chen, MD
Shawn S. Groth, MD
Chuong D. Hoang, MD
Viswam S. Nair, MD
Joseph B. Shrager, MD
Publication date: 01-12-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4780-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diameter of Solid Tumor Component Alone Should be Used to Establish T Stage in Lung Adenocarcinoma

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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