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Prognostic Classification of Multiple Primary Lung Cancers Based on a Ground-Glass Opacity Component.
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- Additional Information
- Source:
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 15030100R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6259 (Electronic) Linking ISSN: 00034975 NLM ISO Abbreviation: Ann Thorac Surg Subsets: MEDLINE
- Publication Information:
Publication: Amsterdam : Elsevier
Original Publication: Boston.
- Subject Terms:
Carcinoma, Non-Small-Cell Lung/
*mortality ;
Carcinoma, Non-Small-Cell Lung/
*pathology ;
Lung Neoplasms/
*pathology ;
Neoplasms, Multiple Primary/
*mortality ;
Neoplasms, Multiple Primary/
*pathology ;
Pneumonectomy/
*methods;
Aged ;
Aged, 80 and over ;
Biopsy, Needle ;
Carcinoma, Non-Small-Cell Lung/
classification ;
Carcinoma, Non-Small-Cell Lung/
surgery ;
Cohort Studies ;
Disease-Free Survival ;
Female ;
Hospitals, University ;
Humans ;
Immunohistochemistry ;
Japan ;
Kaplan-Meier Estimate ;
Lung Neoplasms/
classification ;
Lung Neoplasms/
mortality ;
Lung Neoplasms/
surgery ;
Male ;
Middle Aged ;
Neoplasms, Multiple Primary/
classification ;
Neoplasms, Multiple Primary/
surgery ;
Pneumonectomy/
mortality ;
Prognosis ;
Proportional Hazards Models ;
Retrospective Studies ;
Risk Assessment ;
Survival Analysis ;
Tomography, X-Ray Computed/
methods - Abstract:
Background: We evaluated the prognostic impact of the presence of a ground-glass opacity (GGO) component on thin-section computed tomography for the refined clinical T classification of multiple primary lung cancers.
Methods: We reviewed 272 surgically resected, clinically node-negative multiple lung cancers. Dominant tumors were classified into 2 groups based on the presence of a GGO component; that is, a GGO tumor (consolidation tumor ratio, 0 to <1.0) or pure-solid (PS) tumor (consolidation tumor ratio, 1.0). Furthermore, multifocal GGOs (MFGGOs) were defined as lesions showing a GGO component for all tumors. Their prognoses were evaluated using Cox proportional hazard model.
Results: There were 153 MFGGOs (56%) with a significantly better 5-year overall survival than non-MFGGOs (97.2% vs 68.5%, P < .001). A multivariable analysis revealed that MFGGO and absence of nodal involvement were independently significant prognosticators of better survival (P = .007 and P = .012, respectively). Furthermore, among the patients of non-MFGGO groups, multivariate analysis showed that a PS + PS pattern and presence of nodal involvement were independently significant prognosticators of poorer survival (P = .008 and P = .001, respectively). We divided the tumors into 3 groups based on the results and focusing on the presence of a GGO; that is, MFGGO (n = 153), PS + additional GGO (n = 81), and PS + PS (n = 38). The 5-year overall survival was clearly split among them: MFGGO, 97.2%; PS + additional GGO, 82.1%; and PS + PS, 41.3% (P < .001).
Conclusions: Our results suggest that presence of a GGO component has the ability to distinguish the survival even for multiple lung cancers. Further investigations including multicenter trials are certainly warranted to address the revision of T variable of multiple lung cancers considering a presence of GGO component.
(Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Publication Date:
Date Created: 20191009 Date Completed: 20200428 Latest Revision: 20200428
- Publication Date:
20231215
- Accession Number:
10.1016/j.athoracsur.2019.09.008
- Accession Number:
31593656
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