Abstract
Purpose
In the most recent (eighth) edition of the TNM classification, the clinical T descriptor has been adapted to measure the consolidation size of sub-solid lung cancer. Sub-centimeter non-small cell lung cancer (NSCLC) has thereby been subclassified into three groups: Tis, T1mi, and T1a; however, the revision has not been validated well. Thus, we investigated the clinicopathological characteristics and long-term oncological outcomes of sub-centimeter NSCLCs based on the solid size.
Methods
The subjects of this retrospective review were 99 patients who underwent complete resection for NSCLC with ≤ 1 cm in consolidation size on computed tomography (CT). Survival was reanalyzed after reclassification according to the new TNM classification.
Results
This cohort consisted of 14 patients with cTis tumors, 18 with cT1mi tumors, and 67 with cT1a tumors. Among the patients with tumors classified as cT1a, two had lymph node metastasis and two had vascular invasion. The cumulative incidences of recurrence at 5 and 10 years were 0% for cTis/cT1mi tumors, and 4.5% and 6.1% for cT1a tumors, respectively.
Conclusions
There may be pathological and survival differences between cTis/cT1mi tumors and cT1a tumors, but not between cTis tumors and cT1mi tumors.
Similar content being viewed by others
References
Brierley JD, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumors. 8th ed. Hoboken: Wiley-Blackwell; 2017.
Rami-Porta R, Bolejack V, Crowley J, Ball D, Kim J, Lyons G, et al. The IASLC lung cancer staging project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol. 2015;10:990–1003.
Travis WD, Asamura H, Bankier AA, Beasley MB, Detterbeck F, Flieder DB, et al. The IASLC lung cancer staging project: proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2016;11:1204–23.
Kishi K, Homma S, Kurosaki A, Motoi N, Kohno T, Nakata K, et al. Small lung tumors with the size of 1 cm or less in diameter: clinical, radiological, and histopathological characteristics. Lung Cancer. 2004;44:43–51.
Sakurai H, Nakagawa K, Watanabe S, Asamura H. Clinicopathologic features of resected subcentimeter lung cancer. Ann Thorac Surg. 2015;99:1731–8.
Hattori A, Matsunaga T, Hayashi T, Takamochi K, Oh S, Suzuki K. Prognostic impact of the findings on thin-section computed tomography in patients with subcentimeter non-small cell lung cancer. J Thorac Oncol. 2017;12:954–62.
Zhao W, Wang H, Xie J, Tian B. A clinicopathological study of small lung adenocarcinoma 1 cm or less in size: emphasis on histological subtypes associated with lymph node metastasis and recurrence. Int J Surg Pathol. 2017. https://doi.org/10.1177/1066896917721649.
Wittekind C, Union for international cancer C. TNM supplement: a commentary on uniform use. Wiley-Blackwell, Hoboken, 2012.
Suzuki K, Koike T, Asakawa T, Kusumoto M, Asamura H, Nagai K, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical IA lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol. 2011;6:751–6.
Ito M, Miyata Y, Kushitani K, Yoshiya T, Mimae T, Ibuki Y, et al. Prediction for prognosis of resected pT1a-1bN0M0 adenocarcinoma based on tumor size and histological status: relationship of TNM and IASLC/ATS/ERS classifications. Lung Cancer. 2014;85:270–5.
Nakamura S, Fukui T, Taniguchi T, Usami N, Kawaguchi K, Ishiguro F, et al. Prognostic impact of tumor size eliminating the ground glass opacity component: modified clinical T descriptors of the tumor, node, metastasis classification of lung cancer. J Thorac Oncol. 2013;8:1551–7.
Yanagawa N, Shiono S, Abiko M, Ogata S-Y, Sato T, Tamura G. New IASLC/ATS/ERS classification and invasive tumor size are predictive of disease recurrence in stage I lung adenocarcinoma. J Thorac Oncol. 2013;8:612–8.
Aokage K, Miyoshi T, Ishii G, Kusumoto M, Nomura S, Katsumata S, et al. Clinical and pathological staging validation in the eighth edition of the TNM classification for lung cancer: correlation between solid size on thin-section computed tomography and invasive size in pathological findings in the new T classification. J Thorac Oncol. 2017;12:1403–12.
Son JY, Lee HY, Lee KS, Kim J-H, Han J, Jeong JY, et al. Quantitative CT analysis of pulmonary ground-glass opacity nodules for the distinction of invasive adenocarcinoma from pre-invasive or minimally invasive adenocarcinoma. PLoS ONE. 2014;9:e104066.
Mimae T, Miyata Y, Tsutani Y, Mimura T, Nakayama H, Okumura S, et al. What are the radiologic findings predictive of indolent lung adenocarcinoma? Jpn J Clin Oncol. 2015;45:367–72.
Wilshire CL, Louie BE, Manning KA, Horton MP, Castiglioni M, Gorden JA, et al. Radiologic evaluation of small lepidic adenocarcinomas to guide decision making in surgical resection. Ann Thorac Surg. 2015;100:979–88.
Yamada N, Kusumoto M, Maeshima A, Suzuki K, Matsuno Y. Correlation of the solid part on high-resolution computed tomography with pathological scar in small lung adenocarcinomas. Jpn J Clin Oncol. 2007;37:913–7.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None declared.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Goto, M., Kawaguchi, K., Fukui, T. et al. Verification of T descriptor with consolidation size for sub-centimeter non-small cell lung cancer. Surg Today 49, 907–912 (2019). https://doi.org/10.1007/s00595-019-01821-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-019-01821-w