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Prognostic impact of a ground glass opacity component in the clinical T classification of non-small cell lung cancer.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2017 Dec; Vol. 154 (6), pp. 2102-2110.e1. Date of Electronic Publication: 2017 Sep 01. - Publication Year :
- 2017
-
Abstract
- Objective: To determine whether solid component size and the presence of a ground glass opacity (GGO) component are independently associated with survival outcomes in patients with early-stage non-small cell lung cancer (NSCLC) using the eighth edition Lung Cancer Stage Classification.<br />Methods: We retrospectively evaluated 1029 surgically resected early-stage NSCLCs. T categories were assigned based on solid component size using the eighth classification. All tumors were classified into 1 of 2 groups: the GGO group or the solid group. We evaluated the prognostic impact of several clinicopathological variables in clinical T classification using a Cox proportional hazard model.<br />Results: On multivariable analysis, the presence of a GGO component (hazard ratio [HR], 0.314; 95% confidence interval [CI], 0.181-0.529: P < .001) and solid component size (HR, 1.021; 95% CI, 1.006-1.036; P = .006) were identified as independently significant prognostic factors of overall survival. However, after accounting for the presence of a GGO component, neither maximum tumor size nor solid component size added to the prediction of long-term survival. Moreover, tumor size significantly affected survival outcome only in the solid group (HR, 1.020; 95% CI, 1.006-1.034; P = .004). Survival was excellent at ≥90% despite the revised T categories, provided that the tumor had a ground glass appearance. Meanwhile, tumor size significantly affected survival only in the solid group (P < .001).<br />Conclusions: The presence of a GGO component is a significant prognostic factor in early-stage NSCLC. External validation is required to assess whether it should be adopted as a novel factor in clinical T staging.<br /> (Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung diagnostic imaging
Carcinoma, Non-Small-Cell Lung mortality
Carcinoma, Non-Small-Cell Lung therapy
Female
Humans
Lung Neoplasms diagnostic imaging
Lung Neoplasms mortality
Lung Neoplasms therapy
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Tumor Burden
Young Adult
Carcinoma, Non-Small-Cell Lung pathology
Lung Neoplasms pathology
Neoplasm Staging
Subjects
Details
- Language :
- English
- ISSN :
- 1097-685X
- Volume :
- 154
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 28947198
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2017.08.037