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Reappraising the clinical usability of consolidation-to-tumor ratio on CT in clinical stage IA lung cancer

Authors
  • Yoon, Dong Woog
  • Kim, Chu Hyun
  • Hwang, Soohyun
  • Choi, Yoon-La
  • Cho, Jong Ho
  • Kim, Hong Kwan
  • Choi, Yong Soo
  • Kim, Jhingook
  • Shim, Young Mog
  • Shin, Sumin
  • Lee, Ho Yun
Type
Published Article
Journal
Insights into Imaging
Publisher
Springer-Verlag
Publication Date
Jun 17, 2022
Volume
13
Identifiers
DOI: 10.1186/s13244-022-01235-2
PMID: 35715654
PMCID: PMC9206049
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Objectives Ground-glass opacity (GGO) on computed tomography is associated with prognosis in early-stage non-small cell lung cancer (NSCLC) patients. However, the stratification of the prognostic value of GGO is controversial. We aimed to evaluate clinicopathologic characteristics of early-stage NSCLC based on the consolidation-to-tumor ratio (CTR), conduct multi-pronged analysis, and stratify prognosis accordingly. Methods We retrospectively investigated 944 patients with clinical stage IA NSCLC, who underwent curative-intent lung resection between August 2018 and January 2020. The CTR was measured and used to categorize patients into six groups (1, 0%; 2, 0–25%; 3, 25–50%; 4, 50–75%; 5, 75–100%; and 6, 100%). Results Pathologic nodal upstaging was found in 1.8% (group 4), 9.0% (group 5), and 17.4% (group 6), respectively. The proportion of patients with a high grade of tumor-infiltrating lymphocytes tended to decrease as the CTR increased. In a subtype analysis of patients with adenocarcinoma, all of the patients with predominant micro-papillary patterns were in the CTR > 50% groups, and most of the patients with predominant solid patterns were in group 6 (47/50, 94%). The multivariate analysis demonstrated that CTR 75–100% (hazard ratio [HR], 3.85; 95% confidence interval [CI], 1.58–9.36) and CTR 100% (HR, 5.58; 95% CI, 2.45–12.72) were independent prognostic factors for DFS, regardless of tumor size. Conclusion We demonstrated that the CTR could provide various noninvasive clinicopathological information. A CTR of more than 75% is the factor associated with a poor prognosis and should be considered when making therapeutic plans for patients with early-stage NSCLC.

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