Evaluation of solid portions in non-small cell lung cancer—the solid part is not always measurable for clinical T factor

2020 ◽  
Vol 51 (1) ◽  
pp. 114-119
Author(s):  
Mariko Fukui ◽  
Kazuya Takamochi ◽  
Takehiro Ouchi ◽  
Yutaro Koike ◽  
Takashi Yaguchi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Tumour Size ◽  
Clinical Stage ◽  
Ground Glass Opacity ◽  
Solid Tumours ◽  
Solid Component ◽  
Imaging Features ◽  
Solid Portion ◽  
Component Size

Abstract Background Solid component size on thin-section computed tomography is used for T-staging according to the eighth edition of the Tumor Node Metastasis classification of lung cancer. However, the feasibility of using the solid component to measure clinical T-factor remains controversial. Methods We evaluated the feasibility of measuring the solid component in 859 tumours, which were suspected cases of primary lung cancers, requiring surgical resection regardless of the procedure or clinical stage. After excluding 126 pure ground-glass opacity tumours and 450 solid tumours, 283 part-solid tumours were analysed to determine the frequency of cases where the measurement of the solid portion was difficult along with the associated cause. Pathological invasiveness was also evaluated. Results The solid portion of 10 lesions in 283 part-solid nodules was difficult to measure due to an underlying lung disease (emphysema and pneumonitis). The solid portion of 62 lesions (21.9%) without emphysema and pneumonitis was difficult to measure due to imaging features of the tumours. Among the 62 patients, five had no malignancy and one with a tumour size of 33 mm had nodal metastasis. There were 56 lesions with a tumour size of ≤30 mm, wherein nodal metastases, vascular and/or lymphatic invasions were not observed. Conclusion For one-fifth of the part-solid tumours, measurement of the solid component was difficult. Moreover, these lesions had low invasiveness, especially in T1. The measurement of the solid portion and the classification of T1 in 1-cm increments may be complex.

scholarly journals Identification of High-Risk of Recurrence in Clinical Stage I Non-Small Cell Lung Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Yasuhiro Tsutani ◽  
Yoshihisa Shimada ◽  
Hiroyuki Ito ◽  
Yoshihiro Miyata ◽  
Norihiko Ikeda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Clinical Stage ◽  
Small Cell ◽  
Stage I ◽  
Solid Component ◽  
Small Cell Lung ◽  
Risk Of Recurrence ◽  
Component Size ◽  
Solid Type

ObjectiveThis study aimed to identify patients at a high risk of recurrence using preoperative high-resolution computed tomography (HRCT) in clinical stage I non-small cell lung cancer (NSCLC).MethodsA total of 567 patients who underwent screening and 1,216 who underwent external validation for clinical stage I NSCLC underwent lobectomy or segmentectomy. Staging was used on the basis of the 8th edition of the tumor–node–metastasis classification. Recurrence-free survival (RFS) was estimated using the Kaplan–Meier method, and the multivariable Cox proportional hazards model was used to identify independent prognostic factors for RFS.ResultsA multivariable Cox analysis identified solid component size (hazard ratio [HR], 1.66; 95% confidence interval [CI] 1.30–2.12; P < 0.001) and pure solid type (HR, 1.82; 95% CI 1.11–2.96; P = 0.017) on HRCT findings as independent prognostic factors for RFS. When patients were divided into high-risk (n = 331; solid component size of >2 cm or pure solid type) and low-risk (n = 236; solid component size of ≤2 cm and part solid type) groups, there was a significant difference in RFS (HR, 5.33; 95% CI 3.09–9.19; 5-year RFS, 69.8% vs. 92.9%, respectively; P < 0.001). This was confirmed in the validation set (HR, 5.32; 95% CI 3.61–7.85; 5-year RFS, 72.0% vs. 94.8%, respectively; P < 0.001).ConclusionsIn clinical stage I NSCLC, patients with a solid component size of >2 cm or pure solid type on HRCT were at a high risk of recurrence.

Oncologic outcomes of segmentectomy versus lobectomy for radiologically aggressive small-sized lung cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8525-8525
Author(s):  
Atsushi Kamigaichi ◽  
Yasuhiro Tsutani ◽  
Takahiro Mimae ◽  
Yoshihiro Miyata ◽  
Kentaro Imai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Clinical Stage ◽  
Multivariable Analysis ◽  
Standardized Uptake Value ◽  
Ground Glass Opacity ◽  
Oncologic Outcomes ◽  
Smoking History ◽  
High Resolution Computed Tomography ◽  
Significant Difference

8525 Background: Despite increasing evidence of favorable outcomes after segmentectomy for indolent lung cancer, such as ground glass opacity-dominant tumors, the adaptation of segmentectomy for radiologically aggressive lung cancer remains controversial. We attempted to elucidate oncologic outcomes after segmentectomy for radiologically aggressive lung cancer. Methods: Data from a multicenter database of 1353 patients with completely resected clinical Stage IA1–IA2 lung cancer at three institutions were retrospectively analyzed to identify radiologically aggressive lung cancer and compare outcomes of segmentectomy versus lobectomy in patients with radiologically aggressive lung cancer using propensity score matching. Results: Multivariable analysis showed that consolidation to maximum tumor (C/T) ratio on preoperative high-resolution computed tomography ( P= 0.037) and maximum standardized uptake value (SUVmax) on 18-fluorodeoxyglucose positron emission tomography/computed tomography ( P= 0.029) were independent predictors of recurrence-free survival (RFS). The criteria for radiologically aggressive lung cancer were determined as C/T ratio ≥ 0.8 or SUVmax ≥ 2.5, for which 522 patients were identified. RFS and overall survival (OS) were significantly worse in patients with aggressive lung cancer (5-year RFS, 83.3%; 5-year OS, 89.4%) than in those without the same (5-year RFS, 97.0%; P< 0.0001; 5-year OS, 97.3%; P< 0.0001). Among patients with aggressive lung cancer, no significant difference in RFS and OS was found between those undergoing lobectomy (n = 392) (5-year RFS, 81.3%; 5-year OS, 88.3%) and segmentectomy (n = 130) (5-year RFS, 90.0%; P= 0.33; 5-year OS, 92.3%; P= 0.76). Among the 111 pairs propensity matched for age, sex, smoking history, solid tumor size, C/T ratio, SUVmax, tumor location, clinical stage, and histology, similar RFS and OS were found between those undergoing lobectomy (5-year RFS, 83.3%; 5-year OS, 88.3%) and segmentectomy (5-year RFS, 90.9%; P= 0.92; 5-year OS, 94.5%). Conclusions: For radiologically aggressive small-sized lung cancer, oncologic outcomes of segmentectomy were equivalent to those of lobectomy.

scholarly journals Importance of Ground Glass Opacity Component in Clinical Stage IA Radiologic Invasive Lung Cancer

2017 ◽  
Vol 104 (1) ◽  
pp. 313-320 ◽  
Author(s):  
Aritoshi Hattori ◽  
Takeshi Matsunaga ◽  
Kazuya Takamochi ◽  
Shiaki Oh ◽  
Kenji Suzuki
Keyword(s):  
Lung Cancer ◽  
Clinical Stage ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals Towards the 9th Edition of the Tumour, Node and Metastasis Classification of Lung Cancer. A Historical Appraisal and Future Perspectives

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Ramón Rami-Porta
Keyword(s):  
Lung Cancer ◽  
International Association ◽  
Tumour Size ◽  
Primary Tumour ◽  
Cancer Control ◽  
Regional Lymph Nodes ◽  
Lung Cancers ◽  
Lung Cancer Patients ◽  
Pathologic Staging

Since 1966 the classification of anatomic extent of lung cancer, based on the primary tumour (T), the loco-regional lymph nodes (N) and the metastases (M) has been used in the management of lung cancer patients. Developed by Pierre Denoix, it was adopted by the Union for International Cancer Control and the American Joint Committee on Cancer. Clifton Mountain revised the second through the sixth editions based on a North American database of more than 5000 patients. For the seventh and the eighth editions, the International Association for the Study of Lung Cancer (IASLC) collected international databases of around 100,000 patients worldwide that allowed the introduction of innovations in both editions, namely the subdivision of the T and M categories based on tumour size and on the location and number of metastases, respectively. The revisions also showed the prognostic relevance of the quantification of nodal disease, and proposed recommendations on how to measure tumour size for solid lung cancers, part-solid adenocarcinomas, and for lung cancers removed after induction therapy. Despite the innovations, prognosis based on the anatomic extent is limited, because prognosis depends on factors related to the tumour, the patient and the environment. For the 9th edition, these factors, especially genetic biomarkers, will be combined in prognostic groups to refine prognosis at clinical and pathologic staging. To achieve this challenging objective, international cooperation is essential, and the IASLC Staging and Prognostic Factors Committee counts on it for the development of the 9th edition due to be published in 2024.

scholarly journals Clinical Pattern and Management of Retroperitoneal Teratomas in a Tertiary Paediatric Centre: A Retrospective Study

2021 ◽  
Author(s):  
Prasanta Kumar Tripathy ◽  
Pradeep Kumar Jena ◽  
Kaumudee Pattnaik
Keyword(s):  
Retrospective Study ◽  
Current Knowledge ◽  
Tumour Size ◽  
Mature Teratoma ◽  
Tertiary Care ◽  
Solid Tumours ◽  
Preoperative Imaging ◽  
Imaging Features ◽  
Complete Excision ◽  
Paediatric Hospital

Introduction: Retroperitoneal Teratomas (RPT) are rare germ cell tumours. Preoperative imaging features often overestimate the tumour size and may be misleading. Surgical exploration of RPT is a challenge because of enormous size and adherence to surrounding organs. The current knowledge on childhood RPT is limited due to rarity of these cases and limited number of studies. Aim: To analyse the demographic pattern, clinical profile and outcome of RPTs managed in a tertiary care paediatric hospital. Materials and Methods: This retrospective study was conducted on hospital records of the children between June 2013 and May 2020. The diagnosis was based on clinical, radiological, intraoperative findings and histopathology and data were collected for demographic pattern, clinical findings, pathological features and outcomes. Statistical analysis was done using Microsoft Excel software. Fisher’s-exact test was used for comparison between various groups. Results: Out of 88 cases of intra-abdominal solid tumours operated during the study period, RPT was found in 16 cases (18.18%). A male preponderance was observed among RPT patients in comparison to other intra-abdominal solid tumours (p=0.26) and 12 patients (75%) were below five years of age. Complete excision of teratoma was performed in all cases. Benign mature teratoma was detected in 81% cases and immature teratoma in 18%. Additionally, two rare observations were made in the present study: (i) In one patient, the histology revealed; teratoma with papillary carcinoma of thyroid as malignant component and chemotherapy was advised; (ii) renal atrophy secondary to RPT was found in another patient. There was no mortality or tumour recurrence; as monitored by serum Alpha-Fetoprotein (AFP). Conclusion: RPTs are uncommon childhood tumours, which usually present before five years of age. Complete excision is possible, without damage to surrounding organs, as they are mostly benign. But, finding of malignant component in the tumour warrants further chemotherapy.

scholarly journals Which T descriptor is more predictive of recurrence after sublobar resection: whole tumour size versus solid component size?

2018 ◽  
Vol 54 (6) ◽  
pp. 1028-1036 ◽  
Author(s):  
Hang Su ◽  
Chenyang Dai ◽  
Yunlang She ◽  
Yijiu Ren ◽  
Lei Zhang ◽  
...  
Keyword(s):  
Tumour Size ◽  
Solid Component ◽  
Sublobar Resection ◽  
Component Size

Towards the 9th Edition of the Tumour, Node and Metastasis Classification of Lung Cancer. A Historical Appraisal and Future Perspectives.

2019 ◽  
Author(s):  
Ramón RAMI-PORTA
Keyword(s):  
Lung Cancer ◽  
International Association ◽  
Tumour Size ◽  
Primary Tumour ◽  
Cancer Control ◽  
Regional Lymph Nodes ◽  
Lung Cancers ◽  
Lung Cancer Patients ◽  
Pathologic Staging

Since 1966 the classification of anatomic extent of lung cancer, based on the primary tumour (T), the loco-regional lymph nodes (N) and the metastases (M) has been used in the management of lung cancer patients. Developed by Pierre Denoix, it was adopted by the Union for International Cancer Control and the American Joint Committee on Cancer. Clifton Mountain revised the second through the sixth editions based on a North American database of more than 5000 patients. For the seventh and the eighth editions, the International Association for the Study of Lung Cancer (IASLC) collected international databases of around 100,000 patients worldwide that allowed the introduction of innovations in both editions, namely the subdivision of the T and M categories based on tumour size and on the location and number of metastases, respectively. The revisions also showed the prognostic relevance of the quantification of nodal disease, and proposed recommendations on how to measure tumour size for solid lung cancers, part-solid adenocarcinomas, and for lung cancers removed after induction therapy. Despite the innovations, prognosis based on the anatomic extent is limited, because prognosis depends on factors related to the tumour, the patient and the environment. For the 9th edition, these factors, especially genetic biomarkers, will be combined in prognostic groups to refine prognosis at clinical and pathologic staging. To achieve this challenging objective, international cooperation is essential, and the IASLC Staging and Prognostic Factors Committee counts on it for the development of the 9th edition due to be published in 2024.

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