Dataset Information

Impact of ground glass opacity in a three-dimensional analysis for pathological findings and prognosis in stage IA pure solid lung cancer.

ABSTRACT:

Background

We investigated whether a three-dimensional (3D) analysis could correct the discrepancy between conventional computed tomography findings and pathological findings and contribute to prognostic stratification in early pure solid lung cancer.

Methods

A total of 370 patients with two-dimensional (2D) pure solid, clinical stage IA non-small cell lung cancer (NSCLC) who underwent complete resection at our hospital between January 2010 and March 2021 were included in the present study. We classified the patients into the 3D solid group and the 3D ground glass opacity (GGO) group according to the consolidation volume/tumor volume ratio (C/T volume ratio) measured using a Synapse Vincent 3D analysis workstation, and compared the pathological findings and prognosis between the two groups.

Results

There were 142 (38.4%) patients in the 3D GGO group. Lepidic lesions were significantly more frequent in the 3D GGO group (27.6% vs. 59.2%, P<0.001). Lymphatic invasion, vascular invasion and lymph node metastasis were significantly more frequent in the 3D solid group (52.2% vs. 27.5%, P<0.001; 67.5% vs. 43.0%, P<0.001; 22.3% vs. 11.2%, P=0.04). A Cox proportional hazards multivariate analysis for overall survival (OS) and recurrence-free survival (RFS) showed that 3D solid was an independent poor prognostic factor [hazard ratio (HR): 1.981, P=0.02; HR: 1.815, P=0.02]. Kaplan-Meier curves for 5-year OS (74.1% vs. 87.8%, P<0.001) and 5-year RFS (65.6% vs. 84.9%, P<0.001) showed significant differences between the two groups.

Conclusions

The C/T volume ratio determined by a 3D analysis detects GGO and reflects the pathological findings, and further prognostic stratification is possible in early 2D pure solid lung cancer.

SUBMITTER: Tsuchida H

PROVIDER: S-EPMC10407529 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Impact of ground glass opacity in a three-dimensional analysis for pathological findings and prognosis in stage IA pure solid lung cancer.

Tsuchida Hiroyuki H Tanahashi Masayuki M Suzuki Eriko E Yoshii Naoko N Watanabe Takuya T Yobita Shogo S Uchiyama Suiha S Iguchi Kensuke K Nakamura Minori M Endo Takumi T

Journal of thoracic disease 20230717 7

<h4>Background</h4>We investigated whether a three-dimensional (3D) analysis could correct the discrepancy between conventional computed tomography findings and pathological findings and contribute to prognostic stratification in early pure solid lung cancer.<h4>Methods</h4>A total of 370 patients with two-dimensional (2D) pure solid, clinical stage IA non-small cell lung cancer (NSCLC) who underwent complete resection at our hospital between January 2010 and March 2021 were included in the pres ...[more]

PMID: 37559660

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Project description:BackgroundThe prognostic value of ground glass opacity (GGO) in stage IA non-small cell lung cancer (NSCLC) has been widely recognized. However, studies investigating its value in the related stage IB-IIA lung adenocarcinoma (LUAD) remains lacking. The impact of adjuvant chemotherapy (ACT) on pathological stage IB-IIA LUAD is also controversial.Materials and methodsWe retrospectively reviewed the clinical records of 501 patients with pathological stage IB-IIA LUAD at the Sun Yat-sen University Cancer Center from January 2008 to June 2018. We calculated and compared survival curves using the Kaplan-Meier test and log-rank test. Cox regression models were performed to determine independent prognostic factors of disease-free survival (DFS) and overall survival (OS). We established nomograms to predict the OS and DFS of LUAD patients. Calibration and receiver operator characteristic curves were conducted to assess the predictive performance of two nomograms. Based on the nomogram, we identified candidate patients that may most benefit from ACT after surgery.ResultsThe number of patients with pure solid, part GGO, and pure GGO nodules was 240, 242, and 19, respectively, and 125 patients who received ACT. Patients with consolidation-to-tumor ratio (CTR) <0.75 had longer OS (P = 0.026) and DFS (P = 0.003). Pathological tumor size and at least 10 lymph nodes (LNs) resection were independent prognostic factors of both OS and DFS. CTR <0.75 was positively associated with DFS. The C-index of nomograms predicting individual OS and DFS was 0.660 and 0.634, respectively. Based on the nomogram for OS, ACT was found to be a positive prognostic indicator of OS (P = 0.031, HR = 0.5141, 95% CI 0.281-0.942) in patients with nomogram total points ≥5.ConclusionCTR <0.75 is associated with a better DFS in patients with stage IB-IIA LUAD. Nomograms developed by integrating pathological tumor size, at least 10 LNs resection, and CTR ≥0.75 for predicting individual OS and DFS displayed a good predictive capacity and clinical value, which were also proved to be a useful tool for selecting patients most benefiting from ACT.

Project description:Objective Lung adenocarcinoma often includes noninvasive components with postoperative lepidic morphology on pathologic specimens that appear on preoperative high-resolution computed tomography (HRCT) images as ground-glass opacity (GGO). We aimed to disclose the role of GGO on the aggressiveness of pathologically confirmed pure invasive tumors in patients with early-stage lung adenocarcinoma. Methods The prognosis of 932 patients with clinical stage 0-IA and pathologic node-negative lung adenocarcinoma who underwent lobectomy at 3 institutions between 2010 and 2016 was investigated according to the status of GGO and lepidic components. Results The recurrence-free survival (RFS) of patients with pathologically confirmed pure invasive tumors was worse without (n = 81) than with (n = 43) GGO (69.7%; 95% confidence interval [CI], 57.3%-79.2% vs 90.5%; 95% CI, 76.6%-96.3%, P = .028). The RFS of patients with radiologically confirmed pure solid tumors was worse without (n = 81), than with (n = 173) a lepidic component (69.7%; 95% CI, 57.3%-79.2% vs 85.3%; 95% CI, 77.2%-90.7%, P = .0012). Multivariable Cox regression analysis of overall survival and RFS revealed that pure solid and pure invasive tumors, respectively, determined by HRCT and pathologic assessment together comprised an independent prognostic factor like vascular or pleural invasion for patients with early-stage lung adenocarcinoma. Conclusions Tumors of non–small cell lung cancer with pure solid and pure invasive components were more aggressive than those with some GGO and lepidic components. Complementary HRCT and pathologic findings can predict the malignant aggressiveness of adenocarcinoma. Graphical abstract Recurrence-free survival is significantly worse for patients with pure solid tumors on high-resolution computed tomography without than with lepidic components and for those with postoperative pathologic findings of pure invasive tumors without, than with ground-glass opacity components.

Project description:BackgroundLimited surgery is deemed advantageous due to its potential to minimize damage and preserve a greater extent of functional lung tissue, contingent upon the invasiveness of lung adenocarcinoma (ADC). The aim of this study was to non-invasively predict the invasiveness of ground-glass opacity (GGO) predominant nodules presented on preoperative computed tomography (CT) of ADC patients with clinical stage Ia.MethodsWe constructed a primary cohort comprising 437 clinical stage Ia ADC patients from the Tianjin Medical University Cancer Institute and Hospital and utilized data from 135 patients from the Tianjin Medical University General Hospital for validation. Radiomics features were extracted by the PyRadiomics software and screened by spearman correlation analysis, minimum redundancy maximum relevance and the least absolute shrinkage and selection operator (LASSO) regression analysis. The radiomics score (Rad-score) formula was then created by linearly combining the selected features, using their regression coefficients as weights. Univariate analysis followed by multivariable logistic regression were performed to estimate the independent predictors. An initial univariate analysis was followed by a multivariable logistic regression to estimate independent predictors. Area under the curve (AUC) was calculated after the model established through visual nomogram and external validation.ResultsThree hundred and seventy-four patients were pathologically confirmed as invasive ADC (65.4%), and three independent predictors were identified: maximum consolidation diameter (P=0.02), texture (P=0.042) and Rad-score (P<0.001). The combined model showed good calibration with an AUC of 0.911 [95% confidence interval (CI): 0.872, 0.951], compared with 0.883 (95% CI: 0.849, 0.932; DeLong's test P=0.16) and 0.842 (95% CI: 0.801, 0.896; DeLong's test P<0.001) when radiomics or CT semantic features were used alone. Combined prediction model accuracy for validation group was 0.865 (95% CI: 0.816, 0.908), which is reasonable.ConclusionsOur study has provided a non-invasive prediction tool based on radiomics and CT semantic characteristics that can accurately assess the quantitative risk associated with the invasiveness of GGO predominant ADC in clinical stage Ia.

Dataset Information

Impact of ground glass opacity in a three-dimensional analysis for pathological findings and prognosis in stage IA pure solid lung cancer.

Background

Methods

Results

Conclusions

Publications

Impact of ground glass opacity in a three-dimensional analysis for pathological findings and prognosis in stage IA pure solid lung cancer.

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