Prognostic significance of high-resolution CT findings in small peripheral adenocarcinoma of the lung: a retrospective study on 64 patients

• Published in: Lung cancer (Amsterdam, Netherlands) Vol. 36; no. 3; pp. 289 - 295
• Main Authors: Takashima, Shodayu, Maruyama, Yuichiro, Hasegawa, Minoru, Yamanda, Takeshi, Honda, Takayuki, Kadoya, Masumi, Sone, Shusuke
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.06.2002; Elsevier Science
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Aged; Biological and medical sciences; Female; Ground-glass opacity, adenocarcinoma; High-resolution CT, prognosis; Humans; Investigative techniques, diagnostic techniques (general aspects); Lung neoplasm, adenocarcinoma; Lung neoplasm, high-resolution CT; Lung neoplasm, prognosis; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Male; Medical sciences; Middle Aged; Multivariate Analysis; Prognosis; Proportional Hazards Models; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Respiratory system; Retrospective Studies; Survival Analysis; Tomography, X-Ray Computed; Lung neoplasm, high-resolution CT; High-resolution CT, prognosis; Ground-glass opacity, adenocarcinoma; Lung neoplasm, prognosis; Lung neoplasm, adenocarcinoma; Adenocarcinoma; Human; Lung disease; High resolution; Prognosis; Radiodiagnosis; Pathophysiology; Respiratory disease; Image interpretation; Mortality; Exploration; Malignant tumor; Bronchopulmonary; Morbidity; Bronchus disease; Medical imagery; Computerized axial tomography
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/S0169-5002(01)00489-5

Objective: We studied the prognostic importance of high-resolution CT (HRCT) findings in lung adenocarcinomas. Patients and methods: HRCT findings (lesion size, percentage of ground-glass opacity (GGO) areas of lesion, and presence or absence of lobulation, coarse spiculation, air space, pleural tag, and multiplicity of lesion), clinical data (age and surgical method), and pathologic findings (tumor subtypes and presence or absence of nodal metastasis) in 64 consecutive patients with 64 peripheral adenocarcinomas of 20 mm or less (mean, 13 mm), including 36 women and 28 men with a mean age of 64 years were analyzed and correlated with survival of the patients using Kaplan–Meier method and stepwise Cox proportional hazards modeling. Follow-up periods of the patients ranged from 6 to 45 months (mean, 22 months). Tumors were classified into six subtypes (types A–F) according to tumor growth patterns defined by Noguchi et al. Results: Six (9%) of the 64 patients died of lung cancer. In univariate analyses, a significant difference was noted for lesion size ( P=0.043), the percentage of GGO areas ( P=0.005), and tumor subtypes ( P=0.006). Lesion size of <15 mm ( n=35), a lesion with GGO areas of >57% ( n=36), and type A ( n=16) or type B adenocarcinomas ( n=16) indicated a significantly better survival. In multivariate analyses using these three parameters as independent variables, the percentage of GGO areas was the only significant independent factor for survival ( P=0.044, relative risk=0.95). Conclusion: GGO areas measured on HRCT may have an independent prognostic significance of small adenocarcinomas of the lung.