Abstract:
STUDY OBJECTIVES:To define characteristics of surgically curable, early cancers of the lung, we retrospectively studied relationships between thin-section CT (TS-CT) scans, pathologic features, and outcome data in 287 patients with resected small-diameter (< 20 mm) peripheral lung carcinoma. Cases included 260 adenocarcinomas, 16 squamous cell carcinomas, 6 small cell carcinomas, 3 large cell carcinomas, and 2 others. MEASUREMENTS AND RESULTS:All tumors were classified by tumor shadow disappearance rate (TDR) on TS-CT as having either an "air-containing" or "solid-density" pattern. Adenocarcinomas are typically classified into these patterns. Air-containing patterns (n = 136) showed 1% pleural involvement and 2% vascular invasion, with no lymphatic permeation by pathology. Solid-density patterns (n = 124) showed 34% pleural involvement, 42% vascular invasion, and 29% lymphatic permeation. No cases of relapse or death were observed in cases with the air-containing pattern, in contrast to the high relapse and death rate in solid-density cases (p < 0.0001). All non-adenocarcinoma cases (n = 25) had a solid-density pattern, with 4% pleural involvement, 52% vascular invasion, and 44% lymphatic permeation. The overall 5-year survival rate for non-adenocarcinoma was 60%, similar to that for solid-density adenocarcinoma. CONCLUSIONS:When peripheral lung cancers < 20 mm in diameter show air-containing patterns on TS-CT images, surgical outcomes may be favorable with curable disease.
journal_name
Chestjournal_title
Chestauthors
Shimizu K,Yamada K,Saito H,Noda K,Nakayama H,Kameda Y,Nakata Kdoi
10.1378/chest.127.3.871subject
Has Abstractpub_date
2005-03-01 00:00:00pages
871-8issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(15)31097-7journal_volume
127pub_type
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