Volume doubling time of lung cancers detected in a chest radiograph mass screening program: Comparison with CT screening

10575 Background: 1. Recent investigations suggest an accelerated growth rate in BRCA1/2-associated breast cancer. 2. This characteristic may have influence on screening policy. Patients and Methods: BRCA1/2 mutation carriers are regularly observed in a structured surveillance program that comprises annual mammography and MRI-scan in addition to sonography undertaken every six months. We performed a prospective study in approx. 2035 women participating in a breast cancer screening program from 01/1997 until 12/2006. In 9 carriers 10 BRCA-associated breast cancer cases were diagnosed of whom at least one previous examination was available. A calculation of the tumor volume doubling time was performed according to the following algorithm: VDT= log2 × (t2-t1)/logm2 - logm1 (VDT= Volume doubling time; t1 and t2 at the beginning and at the end of the observation period; m1 and m2 size of the tumor at point in time t1 and t2). Results: The 10 cases shown in table 1 prove both high growth rates with VDTs measuring on average 48 days and benign morphologic criteria in early stage disease by all 3 imaging procedures. The VDT for BRCA1-associated tumors was in average 42 days, while the single BRCA2 associated case had a VDT of 102 days. Conclusions: Our data demonstrate a short VDT of 48 days in BRCA1/2 mutation carriers. This is in line with another observational study which identified a tumor doubling time of 45 days for familial tumors in comparison to sporadic tumors with 82 days (Tilanus-Linthorst et al., 2005). These data underline the necessity for a closely meshed screening interval of 6 months. Lit: Tilanus- Linthorst et al., Eur J Cancer. 2005. Jul.41(11):1610–17 [Table: see text] No significant financial relationships to disclose.

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In vivo growth of 60 non-screening detected lung cancers: a computed tomography study

European Respiratory Journal ◽

10.1183/13993003.02183-2017 ◽

2018 ◽

Vol 51 (4) ◽

pp. 1702183

Author(s):

Onno M. Mets ◽

Kaman Chung ◽

Pieter Zanen ◽

Ernst T. Scholten ◽

Wouter B. Veldhuis ◽

...

Keyword(s):

Lung Cancer ◽

Exponential Growth ◽

Doubling Time ◽

Routine Care ◽

Growth Patterns ◽

Growth Behaviour ◽

Lung Cancers ◽

Volume Doubling Time ◽

Volume Doubling

Current pulmonary nodule management guidelines are based on nodule volume doubling time, which assumes exponential growth behaviour. However, this is a theory that has never been validated in vivo in the routine-care target population. This study evaluates growth patterns of untreated solid and subsolid lung cancers of various histologies in a non-screening setting.Growth behaviour of pathology-proven lung cancers from two academic centres that were imaged at least three times before diagnosis (n=60) was analysed using dedicated software. Random-intercept random-slope mixed-models analysis was applied to test which growth pattern most accurately described lung cancer growth. Individual growth curves were plotted per pathology subgroup and nodule type.We confirmed that growth in both subsolid and solid lung cancers is best explained by an exponential model. However, subsolid lesions generally progress slower than solid ones. Baseline lesion volume was not related to growth, indicating that smaller lesions do not grow slower compared to larger ones.By showing that lung cancer conforms to exponential growth we provide the first experimental basis in the routine-care setting for the assumption made in volume doubling time analysis.

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