Prognostic impact of solid-part tumour volume doubling time in patients with radiological part-solid or solid lung cancer. (20th November 2019)

• Record Type: Journal Article
• Authors: Setojima, Yusuke; Shimada, Yoshihisa; Tanaka, Takehiko; Shigefuku, Shunsuke; Makino, Yojiro; Maehara, Sachio; Hagiwara, Masaru; Masuno, Ryuichi; Yamada, Takafumi; Kakihana, Masatoshi; Kajiwara, Naohiro; Ohira, Tatsuo; Ikeda, Norihiko
• Is Part Of: European journal of cardio-thoracic surgery. Volume 57:Number 4(2020)
• Page Start: 763
• Page End: 770
• Publication Date: 2019-11-20
• Subjects: Tumour doubling time -- Computed tomography -- Non-small-cell lung cancer -- Prognosis -- Recurrence; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezz305
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: : OBJECTIVES: The measurement of part-solid and whole tumour sizes in patients with non-small-cell lung cancer (NSCLC) using computed tomography (CT) has been widely accepted for assessing clinical outcomes. Although the volume doubling time (VDT) of a tumour is useful for distinguishing high-risk nodules from low-risk ones, it remains to be clarified whether separate calculation of whole-tumour VDT and solid-part tumour VDT (SVDT) greatly affects the survival rate of patients with radiologically node-negative part-solid or solid NSCLC. METHODS: The study included 258 patients with NSCLC who had radiologically node-negative, part-solid or solid tumours and who had at least 2 preoperative CT scans taken more than 30 days apart followed by radical lobectomy and systemic lymph node dissection between January 2012 and December 2015. Univariable and multivariable analyses of recurrence-free survival were performed using the Cox proportional hazards regression model. RESULTS: The mean whole-tumour VDT and SVDT were 375 and 458 days, respectively. Multivariable analyses demonstrated that whole-tumour VDT ( P = 0.003), SVDT ( P < 0.001), solid-part tumour size, whole-tumour size and comorbidities significantly affected the recurrence-free survival. Using the receiver operating characteristic curve, the cut-off value of the SVDT for recurrence was 215 days, and the 5-year recurrence-free survival rates for patients with SVDT >215 days and those with SVDT <215 days were 85.7% and 43.0%, respectively ( P < 0.001). CONCLUSION: The calculation of SVDT in patients with node-negative, part-solid or solid NSCLC is highly useful for predicting postoperative survival outcomes.