The size of consolidation on thin-section computed tomography is a better predictor of survival than the maximum tumour dimension in resectable lung cancer

Maeyashiki, Tatsuo; Suzuki, Kenji; Hattori, Aritoshi; Matsunaga, Takeshi; Takamochi, Kazuya; Oh, Shiaki

doi:10.1093/ejcts/ezs516

Cited by 102 publications

(78 citation statements)

References 18 publications

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“…Lung adenocarcinomas detected as ground glass opacity (GGO) dominant tumors by high resolution computed tomography (CT) are associated with a good prognosis, and future pathologies are minimally invasive (1)(2)(3). Thus, patients with such tumors are candidates for observation rather than immediate resection.…”

Section: Introductionmentioning

confidence: 99%

Surgical intervention for ground glass dominant lesions: observation or outright resection?

Fukui

Suzuki

Matsunaga

et al. 2017

Japanese Journal of Clinical Oncology

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Background: The management of ground glass opacity (GGO) on computed tomography (CT) remains controversial. Information of the relationship between clinical behavior and pathological invasiveness of GGO is valuable for management. We conducted this retrospective study to establish differences in the pathological invasiveness between GGO with and without changes. Methods: Among 1762 patients, the following criteria was used: (1) maximum tumor diameter of 3 cm or less, (2) tumor having 50% or more GGO and (3) resection after at least three months of follow up. A change of CT findings was defined as an increase in the diameter or consolidation compared with the initial CT. The relationship between preoperative changes and ratio of invasive adenocarcinoma was investigated. Predictors of GGO growth were also examined. Results: There were 250 patients: pure GGO without changes (G-N group; n = 118), pure GGO with changes (G-C group; n = 35), part-solid GGO without changes (S-N group; n = 78), and partsolid GGO with changes (S-C group; n = 20). The ratio of invasive adenocarcinoma in each group was 0.54, 0.89, 0.8, and 0.90. There was a significant difference between the G-N and G-C group (P < 0.001). However, there was no significant difference between the G-C, S-N and S-C group. Multivariate analysis indicated age was a predictor of preoperative changes (OR = 1.953, P = 0.049). Conclusions:The pathological results of part-solid GGO with changes were not different from those without changes. Therefore surgery can be deferred until those lesions demonstrate changes. The pathological results of pure GGO with changes were equivalent to those of partsolid GGO. Therefore, even for pure GGO, follow up is necessary especially in elderly patients.

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Section: Introductionmentioning

confidence: 99%

Surgical intervention for ground glass dominant lesions: observation or outright resection?

Fukui

Suzuki

Matsunaga

et al. 2017

Japanese Journal of Clinical Oncology

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“…Many studies have consistently shown that the ground glass (or histologically the lepidic) component does not affect prognosis-it is the size of a solid (or histologically the invasive) component that matters (7)(8)(9)(10)(11)(12). The current 8 th edition of TNM stage classification assigns the T stage purely on the basis of the solid (clinical stage) or invasive (pathologic stage) component (13).…”

Section: Taking It a Step Furthermentioning

confidence: 99%

Peeling back the onion: addressing nuances of CT screening for lung cancer

Detterbeck

2018

J. Thorac. Dis.

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“…However, the recent use of computed tomography (CT) for the screening of lung cancer and advances in thin-section CT scans has made it possible to detect smaller and fainter lung nodules [3,4]. Moreover, several authors have suggested that lung adenocarcinomas seen as a wide area of ground-glass opacity (GGO) on CT scans are likely to be associated with a good prognosis and in most cases their pathologic features are minimally invasive [5][6][7][8][9]. Thus, patients with these tumors are considered as candidates for limited surgical resection, as confirmed by the prospective JCOG 0201 study in Japan [10].…”

Section: Introductionmentioning

confidence: 99%

Predictors of pathological non-invasive lung cancer with pure-solid appearance on computed tomography to identify possible candidates for sublobar resection

et al. 2015

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The size of consolidation on thin-section computed tomography is a better predictor of survival than the maximum tumour dimension in resectable lung cancer

Abstract: The maximum dimension of the consolidation was an independent unfavourable prognostic factor, regardless of the maximum tumour dimension. This could lead to the more accurate prediction of pathological lymph node metastasis with both GGO and consolidation.

Cited by 102 publications

References 18 publications

Surgical intervention for ground glass dominant lesions: observation or outright resection?

Surgical intervention for ground glass dominant lesions: observation or outright resection?

Peeling back the onion: addressing nuances of CT screening for lung cancer

Predictors of pathological non-invasive lung cancer with pure-solid appearance on computed tomography to identify possible candidates for sublobar resection

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