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Survival with Parenchymal and Pleural Invasion of Non-Small Cell Lung Cancers Less than 30 mm

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机构: [1]Icahn Sch Med Mt Sinai, Dept Radiol, 1 Gustave L Levy Pl,Box 1234, New York, NY 10029 USA [2]Capital Med Univ, Tong Ren Hosp, Dept Diagnost Ultrasound, Beijing, Peoples R China [3]Icahn Sch Med Mt Sinai, Dept Thorac Surg, New York, NY 10029 USA [4]Mt Sinai Sch Med, New York, NY USA [5]Weill Cornell Med Coll, New York, NY USA [6]Cornell Univ, Ithaca, NY 14853 USA [7]CUNY Queens Coll, Ctr Biol Nat Syst, Queens, NY USA [8]Fdn Inst Valenciano Oncol, Valencia, Spain [9]Univ Toronto, Princess Margaret Hosp, Toronto, ON, Canada [10]Azumi Gen Hosp, Nagano, Japan [11]Clin Univ Navarra, Pamplona, Spain [12]Swedish Med Ctr, Seattle, WA USA [13]Christiana Care, Helen F Graham Canc Ctr, Newark, DE USA [14]Natl Canc Inst Regina Elena, Rome, Italy [15]St Agnes Canc Ctr, Baltimore, MD USA [16]LungenZentrum Hirslanden, Zurich, Switzerland [17]Columbia Univ, Med Ctr, New York, NY USA [18]Hadassah Med Org, Jerusalem, Israel [19]Holy Cross Hosp Canc Inst, Silver Spring, MD USA [20]Nebraska Methodist Hosp, Omaha, NE USA [21]South Nassau Communities Hosp, Long Isl City, NY USA [22]Eisenhower Lucy Curci Canc Ctr, Rancho Mirage, CA USA [23]NYU Med Ctr, New York, NY 10016 USA [24]Mills Peninsula Hlth Serv, Dorothy E Schneider Canc Ctr, San Mateo, CA USA [25]SUNY Stony Brook, Stony Brook, NY 11794 USA [26]Waukesha & Oconomowoc Mem Hosp, ProHlth Care Reg Canc Ctr, Oconomowoc, WI USA [27]Maimonides Hosp, Brooklyn, NY 11219 USA [28]Wellstar Hlth Syst, Marietta, GA USA [29]St Joseph Hlth Ctr, St Charles, MO USA [30]Roswell Pk Canc Inst, Buffalo, NY 14263 USA [31]Upstate Med Ctr, Syracuse, NY USA [32]Univ Miami, Jackson Mem Hosp, Miami, FL 33136 USA [33]SUNY, North Shore Long Isl Jewish Hlth Syst, New Hyde Pk, NY USA [34]Sun Yat Sen Univ, Affiliated Hosp 5, Zhuhai, Peoples R China [35]Mercy Med Ctr, Rockville Ctr, NY USA [36]Shin Kong Wu Ho Su Mem Hosp, Taipei, Taiwan [37]Natl Canc Inst China, Beijing, Peoples R China [38]Staten Isl Univ Hosp, Staten Isl, NY USA [39]Cent Main Med Ctr, Lewiston, ME USA [40]Georgia Inst Lung Canc Res, Atlanta, GA USA [41]Valley Hosp Canc Ctr, Paramus, NJ USA [42]McGill Univ, Hlth Grp Physimed, Montreal, PQ, Canada [43]Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA [44]John Muir Canc Inst, Concord, CA USA [45]Atlantic Hlth Morristown Mem Hosp, Morristown, NJ USA [46]Alta Bates Summit Med Ctr, Berkeley, CA USA [47]New York Med Coll, Valhalla, NY 10595 USA [48]St Josephs Hosp, Atlanta, GA USA [49]Mt Sinai Comprehens Canc Ctr, Miami Beach, FL USA [50]Aurora St Lukes Med Ctr, Milwaukee, WI USA [51]City Hope Natl Med Ctr, 1500 E Duarte Rd, Duarte, CA 91010 USA [52]Evanston Northwestern Healthcare Med Grp, Evanston, IL USA [53]Greenwich Hosp, Greenwich, CT USA [54]Our Lady Mercy Med Ctr, Bronx, NY USA [55]Baylor Univ, Med Ctr, Dallas, TX USA [56]Sequoia Hosp, Redwood City, CA USA [57]Glens Falls Hosp, Glens Falls, NY USA [58]Atlantic Med Imaging, Atlantic City, NJ USA [59]Karmanos Canc Inst, Detroit, MI USA [60]Rush Univ, Chicago, IL 60612 USA [61]Bldg Trades, Oak Ridge, TN USA [62]Sharp Mem Hosp & Rehabil Ctr, San Diego, CA USA [63]Newark Beth Israel Med Ctr, Newark, NJ USA [64]Guthrie Canc Ctr, Sayre, PA USA [65]Comprehens Canc Ctr Desert, Palm Springs, CA USA [66]White Plains Hosp, Dickstein Canc Treatment Ctr, White Plains, NY USA [67]Presbyterian Healthcare, Charlotte, NC USA [68]Univ Toledo, 2801 W Bancroft St, Toledo, OH 43606 USA
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关键词: Lung cancer survival Small lung cancers Pleural Lymphatic Vascular invasion

摘要:
Objective: To determine long-term survival of visceral pleural invasion (VPI) and parenchymal invasion (PAI) (angiolymphatic and/or vascular) on survival of NSCLCs less than 30 mm in maximum diameter. Methods: Kaplan-Meier survivals for NSCLCs, with and without VPI and/or PAI, were determined for a prospective cohort of screening participants stratified by pathologic tumor size (<= 10 mm, 11-20 mm, and 21-30 mm) and nodule consistency. Log-rank test statistics were calculated. Results: The frequency of PAI versus VPI was significantly lower in patients with subsolid nodules than in those with solid nodules (4.9% versus 27.7% [p < 0.0001]), and correspondingly, Kaplan-Meier lung cancer survival was significantly higher among patients with subsolid nodules (99.1% versus 91.3% [p = 0.0009]). Multivariable Cox regression found that only tumor diameter (adjusted hazard ratio [HR] = 1.07, 95% confidence interval [CI]: 1.01-1.14, p = 0.02) and PAI (adjusted HR = 3.15, 95% CI: 1.25-7.90, p = 0.01) remained significant, whereas VPI was not significant (p = 0.15). When clinical and computed tomography findings were included with the pathologic findings, Cox regression showed that the risk of dying of lung cancer increased 10-fold (HR = 10.06, 95% CI: 1.35-75.30) for NSCLCs in patients with solid nodules and more than twofold (by a factor of 2.27) in patients with moderate to severe emphysema (HR = 2.27, 95% CI: 1.01-5.11), as well as with increasing tumor diameter (HR = 1.06, 95% CI: 1.01-1.13), whereas PAI was no longer significant (p = 0.19). Conclusions: Nodule consistency on computed tomography was a more significant prognostic indicator than either PAI or VPI. We propose that patients with NSCLC with VPI and a maximum tumor diameter of 30 mm or less not be upstaged to T2 without further large, multicenter studies of NSCLCs, stratified by the new T status and that classification be considered separately for patients with subsolid or solid nodules. (C) 2019 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

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出版当年[2018]版:
大类 | 1 区 医学
小类 | 2 区 肿瘤学 2 区 呼吸系统
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 肿瘤学 1 区 呼吸系统
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出版当年[2017]版:
Q1 RESPIRATORY SYSTEM Q1 ONCOLOGY
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Q1 ONCOLOGY Q1 RESPIRATORY SYSTEM

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第一作者:
第一作者机构: [1]Icahn Sch Med Mt Sinai, Dept Radiol, 1 Gustave L Levy Pl,Box 1234, New York, NY 10029 USA [4]Mt Sinai Sch Med, New York, NY USA
通讯作者:
通讯机构: [1]Icahn Sch Med Mt Sinai, Dept Radiol, 1 Gustave L Levy Pl,Box 1234, New York, NY 10029 USA [4]Mt Sinai Sch Med, New York, NY USA [*1]Department of Radiology, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1234, New York, NY 10029
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