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Clinical Significance of Pleural Attachment and Indentation of Subsolid Nodule Lung Cancer

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Purpose Lung cancers presenting as subsolid nodule commonly have peripheral location, making the cancer-pleura relationship noteworthy. We aimed to evaluate the effect of pleural attachment and/or indentation on visceral pleural invasion (VPI) and recurrence-free survival. Materials and Methods Patients who underwent curative resection of lung cancer as subsolid nodules from April 2007 to January 2016 were retrospectively evaluated. They were divided into four groups according to their relationship with the pleura. Clinical, radiographical, and pathological findings were analyzed. Results Among 404 patients with malignant subsolid nodule, 120 (29.7%) had neither pleural attachment nor indentation, 26 (6.4%) had attachment only, 117 (29.0%) had indentation only, and 141 (34.9%) had both. VPI was observed in nodules of 36 patients (8.9%), but absent in nonsolid nodules and in those without pleural attachment and/or indentation. Compared to subsolid nodules with concurrent pleural attachment and indentation, those with attachment only (odds ratio, 0.12; 95% confidence interval [CI], 0.02 to 0.98) and indentation only (odds ratio, 0.10; 95% CI, 0.03 to 0.31) revealed lower odds of VPI. On subgroup analysis, the size of the solid portion was associated with VPI among those with pleural attachment and indentation (p=0.021). Such high-risk features for VPI were associated with earlier lung cancer recurrence (adjusted hazard ratio, 3.31; 95% CI, 1.58 to 6.91). Conclusion Concurrent pleural attachment and indentation are risk factors for VPI, and the odds increase with larger solid portion in subsolid nodules. Considering the risk of recurrence, early surgical resection could be encouraged in these patients.

Abstract

Purpose Lung cancers presenting as subsolid nodule commonly have peripheral location, making the cancer-pleura relationship noteworthy. We aimed to evaluate the effect of pleural attachment and/or indentation on visceral pleural invasion (VPI) and recurrence-free survival. Materials and Methods Patients who underwent curative resection of lung cancer as subsolid nodules from April 2007 to January 2016 were retrospectively evaluated. They were divided into four groups according to their relationship with the pleura. Clinical, radiographical, and pathological findings were analyzed. Results Among 404 patients with malignant subsolid nodule, 120 (29.7%) had neither pleural attachment nor indentation, 26 (6.4%) had attachment only, 117 (29.0%) had indentation only, and 141 (34.9%) had both. VPI was observed in nodules of 36 patients (8.9%), but absent in nonsolid nodules and in those without pleural attachment and/or indentation. Compared to subsolid nodules with concurrent pleural attachment and indentation, those with attachment only (odds ratio, 0.12; 95% confidence interval [CI], 0.02 to 0.98) and indentation only (odds ratio, 0.10; 95% CI, 0.03 to 0.31) revealed lower odds of VPI. On subgroup analysis, the size of the solid portion was associated with VPI among those with pleural attachment and indentation (p=0.021). Such high-risk features for VPI were associated with earlier lung cancer recurrence (adjusted hazard ratio, 3.31; 95% CI, 1.58 to 6.91). Conclusion Concurrent pleural attachment and indentation are risk factors for VPI, and the odds increase with larger solid portion in subsolid nodules. Considering the risk of recurrence, early surgical resection could be encouraged in these patients.

참고문헌 (30)

  1. Torre LA, "Global cancer statistics, 2012", CA Cancer J Clin, 65, pp.87~108 (2015)
  2. Allemani C, "Global surveillance of cancer survival 1995-2009 : analysis of individual data for 25, 676, 887 patients from 279 population-based registries in 67 countries(CONCORD-2)", Lancet, 385, pp.977~1010 (2015)
  3. National Lung Screening Trial Research Team, "Reduced lung-cancer mortality with low-dose computed tomographic screening", N Engl J Med, 365, pp.395~409 (2011)
  4. Henschke CI, "CT screening for lung cancer : frequency and significance of part-solid and nonsolid nodules", AJR Am J Roentgenol, 178, pp.1053~1057 (2002)
  5. Nakamura S, "Does ground glass opacity-dominant feature have a prognostic significance even in clinical T2aN0M0 lung adenocarcinoma?", Lung Cancer, 89, pp.38~42 (2015)
  6. Ujiie H, "Solid predominant histologic subtype in resected stage I lung adenocarcinoma is an independent predictor of early, extrathoracic, multisite recurrence and of poor postrecurrence survival", J Clin Oncol, 33, pp.2877~2884 (2015)
  7. Seok Y, "Visceral pleural invasion is a significant prognostic factor in patients with partly solid lung adenocarcinoma sized 30 mm or smaller", Thorac Cardiovasc Surg, 66, pp.150~155 (2018)
  8. Kadota K, "Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stage I lung adenocarcinomas", J Thorac Oncol, 10, pp.806~814 (2015)
  9. Lu S, "Spread through Air Spaces(STAS)is an independent predictor of recurrence and lung cancer-specific death in squamous cell carcinoma", J Thorac Oncol, 12, pp.223~234 (2017)
  10. Hsu JS, "Pleural tags on CT scans to predict visceral pleural invasion of nonsmall cell lung cancer that does not abut the pleura", Radiology, 279, pp.590~596 (2016)
  11. Ahn SY, "Predictive CT features of visceral pleural invasion by T1-sized peripheral pulmonary adenocarcinomas manifesting as subsolid nodules", AJR Am J Roentgenol, 209, pp.561~566 (2017)
  12. Zhao LL, "Visceral pleural invasion in lung adenocarcinoma ≤ 3 cm with ground-glass opacity: a clinical, pathological and radiological study", J Thorac Dis, 8, pp.1788~1797 (2016)
  13. Zwirewich CV, "Solitary pulmonary nodule : high-resolution CT and radiologic-pathologic correlation", Radiology, 179, pp.469~476 (1991)
  14. Ko JP, "Lung adenocarcinoma : correlation of quantitative CT findings with pathologic findings", Radiology, 280, pp.931~939 (2016)
  15. Goldstraw P, "The IASLC Lung Cancer Staging Project : proposals for revision of the TNM stage groupings in the forthcoming(Eighth)edition of the TNM classification for lung cancer", J Thorac Oncol, 11, pp.39~51 (2016)
  16. Travis WD, "The IASLC Lung Cancer Staging Project : proposals for the inclusion of broncho-pulmonary carcinoid tumors in the forthcoming(seventh)edition of the TNM Classification for Lung Cancer", J Thorac Oncol, 3, pp.1213~1223 (2008)
  17. Seki N, "Easier understanding of pleural indentation on computed tomography", Intern Med, 46, pp.2029~2030 (2007)
  18. Shimada Y, "Predictive factors of pathologically proven noninvasive tumor characteristics in T1aN0M0 peripheral non-small cell lung cancer", Chest, 141, pp.1003~1009 (2012)
  19. Meniga IN, "Prognostic value of computed tomography morphologic characteristics in stage I non-small-cell lung cancer", Clin Lung Cancer, 11, pp.98~104 (2010)
  20. Zhang H, "The predictive and prognostic values of factors associated with visceral pleural involvement in resected lung adenocarcinomas", Onco Targets Ther, 9, pp.2337~2348 (2016)
  21. Bak SH, "Quantitative CT scanning analysis of pure ground-glass opacity nodules predicts further CT scanning change", Chest, 149, pp.180~191 (2016)
  22. Jiang L, "The impact of visceral pleural invasion in node-negative non-small cell lung cancer : a systematic review and meta-analysis", Chest, 148, pp.903~911 (2015)
  23. Huang H, "Visceral pleural invasion remains a size-independent prognostic factor in stage I nonsmall cell lung cancer", Ann Thorac Surg, 99, pp.1130~1139 (2015)
  24. Liu QX, "Visceral pleural invasion impacts the prognosis of non-small cell lung cancer : a meta-analysis", Eur J Surg Oncol, 42, pp.1707~1713 (2016)
  25. Hattori A, "Visceral pleural invasion is not a significant prognostic factor in patients with a part-solid lung cancer", Ann Thorac Surg, 98, pp.433~438 (2014)
  26. Antony VB, "NHLBI workshop summaries. Pleural cell biology in health and disease", Am Rev Respir Dis, 145, pp.1236~1239 (1992)
  27. Yamamoto T, "Impact of tumor attachment to the pleura measured by a pretreatment CT image on outcome of stage I NSCLC treated with stereotactic body radiotherapy", Radiat Oncol, 10, pp.35~ (2015)
  28. Wang H, "Semiquantitative computed tomography characteristics for lung adenocarcinoma and their association with lung cancer survival", Clin Lung Cancer, 16, pp.e141~e163 (2015)
  29. Naidich DP, "Recommendations for the management of subsolid pulmonary nodules detected at CT : a statement from the Fleischner Society", Radiology, 266, pp.304~317 (2013)
  30. Wang T, "Extent of visceral pleural invasion affects prognosis of resected non-small cell lung cancer : a meta-analysis", Sci Rep, 7, pp.1527~ (2017)

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