46PD - The solid component evaluated on computed tomography can predict the invasiveness and lymph node metastasis in lung adenocarcinoma as well as patho...

Date 06 May 2017
Event ELCC 2017
Session Imaging and locally advanced NSCLC
Topics Imaging, Diagnosis and Staging
Lung and other Thoracic Tumours
Presenter Yukinori Sakao
Citation Annals of Oncology (2017) 28 (suppl_2): ii14-ii16. 10.1093/annonc/mdx086
Authors Y. Sakao1, H. Kuroda1, T. Mizuno1, N. Sakakura1, Y. Yatabe2
  • 1Surgerythoracic C, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP
  • 2Pathology, Aichi Cancer Center Hospital, Nagoya/JP

Abstract

Background

The newly revised TNM classification shows that cT and pT are to be evaluated with solid component on CT and pathological invasive size in adenocarcinoma of the lung. We evaluated the predictive factors for invasiveness, lymph node metastasis and recurrence in patients with adenocarcinomas of the lung, particularly pathological tumor diameters both of gross and invasive size, and solid component diameter using computed tomography (CT) both with lung window settings and mediastinal window settings.

Methods

We evaluated 533 patients with lung adenocarcinomas (diameter, 6–132 mm) who underwent surgical resections. 447 of the 533 have been underwent systematic node dissection. Tumors were examined using CT with thin section conditions (1.25-mm thick: high-resolution CT), with tumor dimensions evaluated under two conditions: lung window (LD) and mediastinal window (MD) settings. Both of the tumor size on CT (LD, MD), consolidation component size on CT with lung window settings (C), preoperative serum carcinoembryonic antigen (CEA) levels, pathological tumor diameter both of gross(GS) and invasive lesion(IS), and pathological status [invasion of lymphatic vessels (ly), vascular vessels (v), pleura (pl), lymph node metastasis] were examined. Area under the curve (AUC) of Receiver Operating Characteristic (ROC) was used for evaluation.

Results

AUCs according to the variables.rnTable: 46PDrn

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
Variablesly(N = 533)v(N = 533)pl (N = 533)Lymph node metastasis (N = 447)Recurrence (N = 447)Correlation coefficient IS and other variables
GS0.730.710.720.720.83N.A
IS0.860.820.790.790.86N.A
LD0.710.700.700.710.790.65
MD0.870.820.810.800.850.80
C0.830.800.790.790.830.78
C/LD0.810.780.750.730.69N.A
CEA0.680.660.690.700.72N.A
rn

GS: pathological gross tumor size, IS: Pathological invasive size, LD: Diameter with lung window settings on CT, MD: diameter with mediastinal window settings on CT, C: consolidation diameter with lung window settings on CT.

rn

Conclusions

The solid component evaluated on computed tomography especially by MD and C can predict the invasiveness and lymph node metastasis in lung adenocarcinoma as well as pathological invasive size.

Clinical trial identification

N.A.

Legal entity responsible for the study

Yukinori Sakao

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.