The impact of histology and ground-glass opacity component on volume doubling time in primary lung cancer

Abstract

Background: Correlations between volume doubling time (VDT) of primary lung cancer (PLC), histology, and ground glass opacity (GGO) components remain unclear. The purpose of this study was to evaluate and compare VDT of PLC in terms of histology and presence or absence of GGO components. Methods: A total of 371 surgically resected PLCs from 2003 to 2015 in our institute were retrospectively reviewed. The VDT was calculated both from the diameters of the entire tumor and of consolidation by using the approximation formula of Schwartz. Results: The median VDTs of adenocarcinoma, squamous cell carcinoma, and others (large cell neuroendocrine carcinomas, small cell lung carcinomas, pulmonary pleomorphic carcinomas, and large cell carcinomas combined) were 261, 70, and 70 days, respectively; these differ significantly (P<0.001). All PLCs with GGO were adenocarcinomas. The VDT of adenocarcinomas with GGO was significantly longer than that of those without GGO (median VDT: 725 and 177 days, respectively), squamous cell carcinomas, and others. When the VDT calculated from the maximum diameter of consolidation component was compared, adenocarcinomas with GGO also showed significantly slower growth than those without GGO (median VDT: 248 versus 177 days, respectively, P=0.040). Conclusions: The VDT of PLCs is longest for adenocarcinomas. VDT was significantly longer in adenocarcinomas with GGO components than in those without such components, irrespective of VDT calculated on the basis of either the entire tumor diameter or consolidation diameter.

Volume and Mass Doubling Time of Lung Adenocarcinoma according to WHO Histologic Classification

“…The calculated volume or mass change of the nodule can also be compared with the appropriate cutoff value to differentiate solid-/micropapillary-predominant adenocarcinoma and squamous cell carcinoma from other subtypes of lung adenocarcinoma. Although small cell lung cancer was not included in this study, it grows rapidly, and the VDT and MDT of small cell lung cancer are usually more rapid than the cutoff values presented in this study (9). Thus, the volumetric assessment of nodule growth between interval CT scans may potentially determine the malignancy and certain subtypes of lung adenocarcinoma noninvasively.…”

“…The median VDT of the lepidic-predominant subtype was over 1000 days, which was significantly longer than that of other subtypes. Even after adjusting for the presence of ground-glass opacities, which have been suggested as contributing factor to tumor doubling time ( 8 9 ), histologic subtype was a significant contributor to the tumor doubling time of lung adenocarcinoma. However, different from the predominant histologic components, the minor components of solid/micropapillary subtypes of lung adenocarcinoma did not have significant correlation with tumor doubling time.…”

“…The growth rate of lung cancer is an important prognostic biomarker reflecting the malignant potential of the tumor ( 5 6 ). Although lung adenocarcinoma typically grows more slowly than lung squamous cell carcinoma or small cell carcinoma, the growth rate of adenocarcinoma ranges widely, with a tumor doubling time from a few months to years ( 7 8 9 10 11 ). The presence of ground-glass opacities, which are common in lepidic-predominant adenocarcinoma and rare in solid- or micropapillary-predominant subtypes, are known to partly contribute to the variation in the growth rate of adenocarcinoma ( 9 12 ).…”

Lung Cancer Radiotherapy: Simulation and Analysis Based on a Multicomponent Mathematical Model

“…In 2013, Benzekry et al recorded a serial of comprehensive experiments for several classical mathematical models for tumor growth [ 29 ]; in their paper, the parameters in many mathematical models include LM and GM for lung and breast cancer are been fitted with the experimental data. As a key reference, their lung data was extracted for estimating and fitting the parameters of our tumor growth model; also, we refined our model parameters according to the dada of the volume double time of lung cancer in some studies [ 30 , 31 ].…”

Subsolid pulmonary nodules: Controversy and perspective

“…Subsolid cancers grow more slowly than solid cancers ( Fig. 5 ) [ 10 ]. In addition, they are less likely to develop lymph node and distant metastases [ 3 ] and do not appear to benefit from routine lymph node dissection at surgery [ 11 ].…”