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Prognostic significance of tumor size of small lung adenocarcinomas evaluated with mediastinal window settings on computed tomography.

Sakao Y, Kuroda H, Mun M, Uehara H, Motoi N, Ishikawa Y, Nakagawa K, Okumura S - PLoS ONE (2014)

Bottom Line: Recurrence-free survival was used for prognosis.Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant factors for lymphatic vessel, vascular vessel or pleural invasion in univariate analyses; areas under the receiver operator curves were 0.60, 0.81, 0.81 and 0.65 for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively.According to the univariate analyses including a logistic regression and ROCs performed for variables with p-values of <0.05 on univariate analyses, our results suggest that measuring tumour size using mediastinal window on high-resolution computed tomography is a simple and useful preoperative prognosis modality in small adenocarcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.

ABSTRACT

Background: We aimed to clarify that the size of the lung adenocarcinoma evaluated using mediastinal window on computed tomography is an important and useful modality for predicting invasiveness, lymph node metastasis and prognosis in small adenocarcinoma.

Methods: We evaluated 176 patients with small lung adenocarcinomas (diameter, 1-3 cm) who underwent standard surgical resection. Tumours were examined using computed tomography with thin section conditions (1.25 mm thick on high-resolution computed tomography) with tumour dimensions evaluated under two settings: lung window and mediastinal window. We also determined the patient age, gender, preoperative nodal status, tumour size, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and pathological status (lymphatic vessel, vascular vessel or pleural invasion). Recurrence-free survival was used for prognosis.

Results: Lung window, mediastinal window, tumour disappearance ratio and preoperative nodal status were significant predictive factors for recurrence-free survival in univariate analyses. Areas under the receiver operator curves for recurrence were 0.76, 0.73 and 0.65 for mediastinal window, tumour disappearance ratio and lung window, respectively. Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant predictive factors for lymph node metastasis in univariate analyses; areas under the receiver operator curves were 0.61, 0.76, 0.72 and 0.66, for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively. Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant factors for lymphatic vessel, vascular vessel or pleural invasion in univariate analyses; areas under the receiver operator curves were 0.60, 0.81, 0.81 and 0.65 for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively.

Conclusions: According to the univariate analyses including a logistic regression and ROCs performed for variables with p-values of <0.05 on univariate analyses, our results suggest that measuring tumour size using mediastinal window on high-resolution computed tomography is a simple and useful preoperative prognosis modality in small adenocarcinoma.

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Receiver operating characteristic analyses for recurrence.Tumour dimension was evaluated using lung window (LD) and mediastinal window (MD) settings. TDR: tumour disappearance ratio (TDR  = 1− MD/LD). Allow indicated a value at 100% sensitivity.
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pone-0110305-g001: Receiver operating characteristic analyses for recurrence.Tumour dimension was evaluated using lung window (LD) and mediastinal window (MD) settings. TDR: tumour disappearance ratio (TDR  = 1− MD/LD). Allow indicated a value at 100% sensitivity.

Mentions: As shown in Table 1, LD findings, MD findings, TDR and nodal status (cN) were significant prognostic factors for disease-free survival on univariate analyses. The AUCs for recurrence were 0.76, 0.73 and 0.65, for MD, TDR and LD, respectively (Figure 1).The 5-year disease-free survival rates according to MD were 98.1% for ≤10 mm (N = 52), 71.0% for 11–≤15 mm (N = 52) and 49.0% for>15 mm (N = 72). (P<0.001) (Figure 2).


Prognostic significance of tumor size of small lung adenocarcinomas evaluated with mediastinal window settings on computed tomography.

Sakao Y, Kuroda H, Mun M, Uehara H, Motoi N, Ishikawa Y, Nakagawa K, Okumura S - PLoS ONE (2014)

Receiver operating characteristic analyses for recurrence.Tumour dimension was evaluated using lung window (LD) and mediastinal window (MD) settings. TDR: tumour disappearance ratio (TDR  = 1− MD/LD). Allow indicated a value at 100% sensitivity.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4217725&req=5

pone-0110305-g001: Receiver operating characteristic analyses for recurrence.Tumour dimension was evaluated using lung window (LD) and mediastinal window (MD) settings. TDR: tumour disappearance ratio (TDR  = 1− MD/LD). Allow indicated a value at 100% sensitivity.
Mentions: As shown in Table 1, LD findings, MD findings, TDR and nodal status (cN) were significant prognostic factors for disease-free survival on univariate analyses. The AUCs for recurrence were 0.76, 0.73 and 0.65, for MD, TDR and LD, respectively (Figure 1).The 5-year disease-free survival rates according to MD were 98.1% for ≤10 mm (N = 52), 71.0% for 11–≤15 mm (N = 52) and 49.0% for>15 mm (N = 72). (P<0.001) (Figure 2).

Bottom Line: Recurrence-free survival was used for prognosis.Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant factors for lymphatic vessel, vascular vessel or pleural invasion in univariate analyses; areas under the receiver operator curves were 0.60, 0.81, 0.81 and 0.65 for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively.According to the univariate analyses including a logistic regression and ROCs performed for variables with p-values of <0.05 on univariate analyses, our results suggest that measuring tumour size using mediastinal window on high-resolution computed tomography is a simple and useful preoperative prognosis modality in small adenocarcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.

ABSTRACT

Background: We aimed to clarify that the size of the lung adenocarcinoma evaluated using mediastinal window on computed tomography is an important and useful modality for predicting invasiveness, lymph node metastasis and prognosis in small adenocarcinoma.

Methods: We evaluated 176 patients with small lung adenocarcinomas (diameter, 1-3 cm) who underwent standard surgical resection. Tumours were examined using computed tomography with thin section conditions (1.25 mm thick on high-resolution computed tomography) with tumour dimensions evaluated under two settings: lung window and mediastinal window. We also determined the patient age, gender, preoperative nodal status, tumour size, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and pathological status (lymphatic vessel, vascular vessel or pleural invasion). Recurrence-free survival was used for prognosis.

Results: Lung window, mediastinal window, tumour disappearance ratio and preoperative nodal status were significant predictive factors for recurrence-free survival in univariate analyses. Areas under the receiver operator curves for recurrence were 0.76, 0.73 and 0.65 for mediastinal window, tumour disappearance ratio and lung window, respectively. Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant predictive factors for lymph node metastasis in univariate analyses; areas under the receiver operator curves were 0.61, 0.76, 0.72 and 0.66, for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively. Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant factors for lymphatic vessel, vascular vessel or pleural invasion in univariate analyses; areas under the receiver operator curves were 0.60, 0.81, 0.81 and 0.65 for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively.

Conclusions: According to the univariate analyses including a logistic regression and ROCs performed for variables with p-values of <0.05 on univariate analyses, our results suggest that measuring tumour size using mediastinal window on high-resolution computed tomography is a simple and useful preoperative prognosis modality in small adenocarcinoma.

Show MeSH
Related in: MedlinePlus