OA07.06 In Early-Stage Lung Adenocarcinomas, Survival by Tumor Size (T) is Further Stratified by Tumor Spread through Air Spaces

AbstractTumor spread through air spaces (STAS) in non-small-cell lung cancer (NSCLC) is known to influence a poor patient outcome, even in patients presenting with early-stage disease. However, the pre-operative diagnosis of STAS remains challenging. With the progress of radiomics-based analyses several attempts have been made to predict STAS based on radiological findings. In the present study, patients with NSCLC which is located peripherally and tumors ≤ 2 cm in size on computed tomography (CT) that were potential candidates for sublobar resection were enrolled in this study. The radiologic features of the targeted tumors on thin-section CT were extracted using the PyRadiomics v3.0 software package, and a predictive model for STAS was built using the t-test and XGBoost. Thirty-five out of 226 patients had a STAS histology. The predictive model of STAS indicated an area under the receiver-operator characteristic curve (AUC) of 0.77. There was no significant difference in the overall survival (OS) for lobectomy between the predicted-STAS (+) and (−) groups (p = 0.19), but an unfavorable OS for sublobar resection was indicated in the predicted-STAS (+) group (p < 0.01). These results suggest that radiomics with machine-learning helped to develop a favorable model of STAS (+) NSCLC, which might be useful for the proper selection of candidates who should undergo sublobar resection.

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P56.01 Semiquantitative Assessment of Tumor Spread Through Air Spaces in a Historic Cohort of Lung Adenocarcinomas Following Open Surgical Resection

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2021.08.567 ◽

2021 ◽

Vol 16 (10) ◽

pp. S1133

Author(s):

W. Shi ◽

H. Khalil ◽

S. Swanson ◽

L. Sholl

Keyword(s):

Surgical Resection ◽

Semiquantitative Assessment ◽

Tumor Spread ◽

Lung Adenocarcinomas ◽

Historic Cohort ◽

Spread Through Air Spaces

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Comment on: 'Correlation of Tumor Spread through Air Spaces and Clinicopathological Characteristics in Surgically Resected Lung Adenocarcinomas'

Lung Cancer ◽

10.1016/j.lungcan.2019.02.016 ◽

2019 ◽

Vol 132 ◽

pp. 150

Author(s):

Tieniu Song ◽

Lili Jiang ◽

Yidan Lin

Keyword(s):

Clinicopathological Characteristics ◽

Tumor Spread ◽

Lung Adenocarcinomas ◽

Spread Through Air Spaces

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Meta-analysis of association between CT-based features and tumor spread through air spaces in lung adenocarcinoma

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01287-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Qifan Yin ◽

Huien Wang ◽

Hongshang Cui ◽

Wenhao Wang ◽

Guang Yang ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Tumor Size ◽

Large Scale ◽

Meta Analysis ◽

Systematic Research ◽

Ct Image ◽

Significant Independent Predictor ◽

Tumor Spread ◽

Solid Nodule ◽

Spread Through Air Spaces

Abstract Objective Spread through air space (STAS) is a novel invasive pattern of lung adenocarcinoma and is also a risk factor for recurrence and worse prognosis of lung adenocarcinoma after sublobar resection. The aims of this study are to evaluate the association between computed tomography (CT)-based features and STAS for preoperative prediction of STAS in lung adenocarcinoma, eventually, which could help us choose appropriate surgical type. Methods Systematic research was conducted to search for studies published before September 1, 2019. The association between CT-based features of radiological tumor size>2 cm、pure solid nodule、 part-solid nodule or Percentage of solid component (PSC)>50% and STAS was evaluated. According to rigorous inclusion and exclusion criteria. Eight studies including 2385 patients published between 2015 and 2018 were finally enrolled in our meta-analysis. Results Our results clearly depicted that there is no significant relationship between radiological tumor size>2 cm and STAS with the combined OR of 1.47(95% CI:0.86–2.51). Meta-analysis of 3 studies showed that pure solid nodule in CT image were more likely to spread through air spaces with pooled OR of 3.10(95%CI2.17–4.43). Meta-analysis of 5 studies revealed the part-solid nodule in CT image may be more likely to appear STAS in adenocarcinoma (ADC) (combined OR:3.10,95%CI:2.17–4.43). PSC>50% in CT image was a significant independent predictor in the diagnosis of STAS in ADC from our meta-analysis with combined OR of 2.95(95%CI:1.88–4.63). Conclusion In conclusion, The CT-based features of pure solid nodule、part-solid nodule、PSC>50% are promising imaging biomarkers for predicting STAS in ADC and may substantially influence the choice of surgical type. In future, more studies with well-designed and large-scale are needed to confirm the conclusion.

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