Prognostic impact of solid-part tumour volume doubling time in patients with radiological part-solid or solid lung cancer

Abstract

OBJECTIVES The measurement of part-solid and whole tumour sizes in patients with non-small-cell lung cancer (NSCLC) using computed tomography (CT) has been widely accepted for assessing clinical outcomes. Although the volume doubling time (VDT) of a tumour is useful for distinguishing high-risk nodules from low-risk ones, it remains to be clarified whether separate calculation of whole-tumour VDT and solid-part tumour VDT (SVDT) greatly affects the survival rate of patients with radiologically node-negative part-solid or solid NSCLC. METHODS The study included 258 patients with NSCLC who had radiologically node-negative, part-solid or solid tumours and who had at least 2 preoperative CT scans taken more than 30 days apart followed by radical lobectomy and systemic lymph node dissection between January 2012 and December 2015. Univariable and multivariable analyses of recurrence-free survival were performed using the Cox proportional hazards regression model. RESULTS The mean whole-tumour VDT and SVDT were 375 and 458 days, respectively. Multivariable analyses demonstrated that whole-tumour VDT (P = 0.003), SVDT (P < 0.001), solid-part tumour size, whole-tumour size and comorbidities significantly affected the recurrence-free survival. Using the receiver operating characteristic curve, the cut-off value of the SVDT for recurrence was 215 days, and the 5-year recurrence-free survival rates for patients with SVDT >215 days and those with SVDT <215 days were 85.7% and 43.0%, respectively (P < 0.001). CONCLUSION The calculation of SVDT in patients with node-negative, part-solid or solid NSCLC is highly useful for predicting postoperative survival outcomes.

Volume doubling time and radiomic features predict tumor behavior of screen-detected lung cancers

“…VDT has been largely utilized as a diagnostic biomarker to discriminate malignant and benign nodules [8,31,53]; however, the thresholds to discriminate between malignant and benign pulmonary nodules are inconsistent. Additionally, prior studies utilized VDT as a biomarker to differentiate between indolent and aggressive lung cancers diagnosed [5,21,36,50,51] and have also utilized VDT as a prognostic factor [32,40,49]. For example, a VDT of less than 400 days was found to be an independent risk factor for poor disease-free survival [32].…”

“…In a study based on chest x-rays, the 5-year survival rate of fast-growing nodules with a VDT of < 113 days was associated with significantly lower than slow-growing nodules with a VDT > 113 days [49]. Setojima et al separated whole tumor VDT (WVDT) and solid-part tumor VDT (SVDT) and identified cut-offs 214 days for WVDT and less than 215 days for SVDT that were associated with poor recurrence-free survival and overall survival [40]. The decision tree in our analysis identified novel VDT thresholds (VDTs of 234 and 279) that exhibited independent capacity to discriminate between high-risk/aggressive tumors and low-risk/indolent tumors.…”

Prediction of surgical outcome by tumor volume doubling time via stereo imaging software in early non-small cell lung cancer

“…Using a method similar to ours, they obtained solid-part tumor volume doubling times and concluded that there was a signi cantly higher 5-year recurrence-free survival rate in the group with VDTs > 215 days. [13] However, they did not include those who underwent segmentectomy or wedge resection. Thus, different inclusion criteria for patients may cause different VDT cut-off points.…”

A Case of Primary Epithelioid Sarcoma of the Pleura

“…Of the proximal-type, only 2 cases of pleural origin have been reported [ 7 , 8 ]. Previous lung cancer studies reported that the average solid-part tumor volume doubling time is 394~458 days [ 9 , 10 ]. In the present case, the volume of the tumor that had disseminated outside the thorax due to drainage was measured using the SYNAPSE VINCENT 3D volume analyzer (Fuji Medical Systems, Tokyo, Japan).…”