Nomogram for Predicting the Risk of Invasive Pulmonary Adenocarcinoma for Pure Ground-Glass Nodules

Wang, Lijie; Shen, Weiyu; Xi, Yong; Liu, Shuai; Zheng, Dawei; Jin, Changchun

doi:10.1016/j.athoracsur.2017.11.012

Cited by 16 publications

(13 citation statements)

References 26 publications

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“…According to one study on solitary peripheral subsolid nodules; speculation, lesion size, vascular convergence and solid proportion are predictive parameters of invasive adenocarcinoma [17] . In another study that used nomogram for predicting risk of invasive pulmonary adenocarcinoma for pure groundglass opacity nodules; lesion size, speculation, lobulation, air bronchogram, vascular convergence, pleural tag were risk factors for being invasive pulmonary adenocarcinoma [18] .…”

Section: Discussionmentioning

confidence: 99%

Factors on nodal up-staging in clinical N0 adenocarcinoma patients who had minimally invasive anatomic lung resections

Cosgun¹,

Kaba²,

Ayalp³

et al. 2019

MIS

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Aim: The incidence of adenocarcinoma among lung cancer patients has increased in recent years. We identified the factors affecting lymph node status in patients with primary lung adenocarcinoma who underwent minimallyinvasive anatomic resection. Methods: We retrospectively analyzed the medical records of primary lung adenocarcinoma patients who underwent minimally-invasive anatomic lung resections and mediastinal lymph node dissection between January 2012 and December 2017. We evaluated lymph node positivity and nodal status in each T and histologic subgroup, tumoral prognostic characteristics, minimally-invasive surgical methods and resection type. Results: Of 473 patients who underwent anatomic resection for lung cancer between January 2012 and December 2017, 274 underwent minimally-invasive anatomic lung resections for primary lung cancer, 158 adenocarcinoma patients were analyzed in this study. Nodal status and number of positive lymph nodes were similar in the stages T1, T2, T3. Lymphovascular invasion (n : 78) and micropapillary predominance tended to be significant predisposing factors for lymph node metastasis. Mean dissected lymph node number was significantly higher in patients who underwent Robot-assisted thoracoscopic surgery compared to Video-assisted thoracoscopic surgery (P < 0.05), and in those who underwent lobectomy compared to segmentectomy (P < 0.05). Conclusion: We were unable to demonstrate a relationship between T stage and N status. Factors contributing to unexpected N positivity were tumor characteristics that could not be identified in the preoperative period. We recommend performing systematic mediastinal lymph node dissection regardless of the size and histopathologic type of adenocarcinoma. In our study, robotic surgery and lobectomy operation showed superiority in dissecting more lymph nodes.

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Section: Discussionmentioning

confidence: 99%

Factors on nodal up-staging in clinical N0 adenocarcinoma patients who had minimally invasive anatomic lung resections

Cosgun¹,

Kaba²,

Ayalp³

et al. 2019

MIS

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“…All specimens were classified according to the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of lung adenocarcinomas. 8 , 9 AAH is a localized, small (usually 0.5 cm or less) proliferation of mildly to moderately atypical type II pneumocytes and/or Clara cells lining the alveolar wall and sometimes, respiratory bronchioles. AIS is a localized small (≤3 cm) adenocarcinoma with growth restricted to neoplastic cells along preexisting alveolar structures (lepidic growth), lacking stromal, vascular, or pleural invasion.…”

Section: Methodsmentioning

confidence: 99%

“… 3 Spiculation was defined as strands extending from the nodule margin into the lung parenchyma without reaching the pleural surface. 9 Lobulation was defined as a part of the nodule surface (except for the portions in contact with the pleura) exhibiting a concave or straightened configuration. 3 A pleural indentation was defined as a trumpet-shaped attenuation extending toward the pleura from the nodule.…”

Section: Methodsmentioning

confidence: 99%

“… 3 A pleural indentation was defined as a trumpet-shaped attenuation extending toward the pleura from the nodule. 9 A vacuole was defined as a small spot of round or ovoid air attenuation occurring within a solitary pulmonary nodule. 12 Vascular convergence was defined with vessels crowding the internal part of the nodule or abnormally angled toward the nodule compared with the normal lung parenchyma.…”

Section: Methodsmentioning

confidence: 99%

“… 12 Vascular convergence was defined with vessels crowding the internal part of the nodule or abnormally angled toward the nodule compared with the normal lung parenchyma. 9

Figure 2 Representative segmentation results of SPN. ( A and C ) A 53-year-old male with SPN.…”

Section: Methodsmentioning

confidence: 99%

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Development and Validation of a Preoperative CT-Based Nomogram to Differentiate Invasive from Non-Invasive Pulmonary Adenocarcinoma in Solitary Pulmonary Nodules

Song¹,

Zhao²,

Zhang³

et al. 2022

CMAR

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Purpose This study aimed to develop and validate a preoperative CT-based nomogram combined with clinical and radiological features for distinguishing invasive from non-invasive pulmonary adenocarcinoma. Patients and Methods A total of 167 patients with solitary pulmonary nodules and pathologically confirmed adenocarcinoma treated between January 2020 and December 2020 at Hebei General Hospital were retrospectively assessed. To evaluate the probability of invasive pulmonary adenocarcinoma, we developed three models, the multivariate logistic regression model, the stepwise logistic regression model, and the cross-validation model. The Akaike information criterion (AIC) was used to compare the relative strength of different models, and the area under the curve (AUC) was used to quantify the predictive accuracy. The best performing model was presented as a nomogram, calibrated and evaluated for clinical utility. Results The stepwise logistic regression model revealed highest and mean attenuations of non-enhanced CT images, and lobulation and vacuole presence were predictive factors of invasive pulmonary adenocarcinoma. This model (AIC = 67.528) with the lowest AIC value compared with that of the multivariate logistic regression model (AIC = 69.301) or the cross-validation model (AIC = 81.216) was identified as the best model, and its AUC value (0.9967; 95% CI, 0.9887–1) was higher than those of the other two models. The calibration curve showed optimal agreement in invasive pulmonary adenocarcinoma probability as predicted by the nomogram and the actual value. Conclusion We developed and validated a nomogram that could estimate the preoperative probability of invasive pulmonary adenocarcinoma in patients with solitary pulmonary nodules, which may be useful in clinical decision-making associated with personalized surgical intervention and therapeutic regimen selection.

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Prediction of histologic types in solid lung lesions using preoperative contrast-enhanced CT

et al. 2023

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Nomogram for Predicting the Risk of Invasive Pulmonary Adenocarcinoma for Pure Ground-Glass Nodules

Cited by 16 publications

References 26 publications

Factors on nodal up-staging in clinical N0 adenocarcinoma patients who had minimally invasive anatomic lung resections

Factors on nodal up-staging in clinical N0 adenocarcinoma patients who had minimally invasive anatomic lung resections

Development and Validation of a Preoperative CT-Based Nomogram to Differentiate Invasive from Non-Invasive Pulmonary Adenocarcinoma in Solitary Pulmonary Nodules

Prediction of histologic types in solid lung lesions using preoperative contrast-enhanced CT

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