Lung Adenocarcinomas Manifesting as Radiological Part-Solid Nodules Define a Special Clinical Subtype

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.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.

Validation of the Eighth Edition Clinical T Categorization System for Clinical Stage IA, Resected Lung Adenocarcinomas: Prognostic Implications of the Ground-Glass Opacity Component

“…19 A different approach, the mixture cure model, was thus employed in this study to investigate the long-term prognostic potential of nodule type. Our study results, which partly coincide with those of past studies, 6,7 reported that the nodule type (i.e., PSN) could be used as a long-term prognostic indicator for surgical candidates with clinical stage IA adenocarcinomas. One may argue that the solid portion size would be different between PSNs and solid nodules even in the same cT category and that such discrepancy would be the potential confounder.…”

“…Recently, a few studies reported the distinct prognosis of PSNs compared with that of solid nodules. [5][6][7] Aokage et al 5 compared the overall survival (OS) of patients with clinical stage I, resected adenocarcinomas characterized by PSNs and solid nodules and revealed that those with PSNs had a more favorable prognosis in clinical stages IA2 and IA3. In addition, Ye et al 6 reported the excellent prognosis of patients with resected adenocarcinomas that appeared as PSNs in clinical stage IA and reported that neither the solid portion size nor the total tumor size could predict the prognosis of PSNs.…”

“…In this context, they even suggested that all PSNs should be grouped in a separate category. 6 Hattori et al 8 proposed a similar revision of the cT category advocating that PSNs should be assigned to the "cT1a" category regardless of the solid component size. These intriguing suggestions require intensive validation using appropriate study populations and analytical methods.…”

“…For instance, cT category has not been used as an independent variable. [5][6][7] In this study, we therefore aimed to validate the prognostic value of cT category in clinical stage IA, resected lung adenocarcinomas using a multivariable analysis that included nodule type, cT category, and their interaction term. Moreover, we aimed to evaluate the independent prognostic role of nodule type (i.e., the presence of GGO) using long-term follow-up data with two distinct survival analysis methods: the Cox proportional hazard model and the mixture cure model.…”

Tumor Atelectasis Gives Rise to a Solid Appearance in Pulmonary Adenocarcinomas on High-Resolution Computed Tomography

“…In contrast, according to Hattori et al, 34 the presence of a GGO component had a strong influence on the prognosis, more than the size of the solid component. Ye et al 15 also found a better survival in patients with subsolid appearance compared with those with solid tumors on HR-CT imaging but had no prognostic features in the subsolid nodules. Possibly, tumor atelectasis may provide an explanation for this finding.…”