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Thin-section computed tomography findings of lung adenocarcinoma with inherent metastatic potential

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Abstract

Purpose

The solid component of lung ground-glass nodules on thin-section computed tomography (TSCT) reflects cancer cell progression and invasiveness. The purpose of this study was to clarify the cut-off value of preoperative TSCT findings in treating a lesion suspected of being adenocarcinoma and to recognize the timing of surgical resection for lung nodules.

Methods

We reevaluated the TSCT findings in 392 patients with clinical stage IA lung adenocarcinoma who underwent surgical resection between 2003 and 2007. We identified the clinical parameters that were most useful for predicting recurrence and identified a cut-off level for each parameter.

Results

Recurrence was observed in 75 (19 %) of 392 patients (median follow-up: 7 years). The size of internal consolidation of a lung nodule (SCL) and the ratio of the SCL to the maximum tumor diameter (C/T ratio) were extracted as independent factors that predicted recurrence. Only 1 (0.3 %) patient each with a lung nodule C/T ratio ≤0.5 and SCL ≤10 mm recurred. These conditions were associated with a significantly better overall survival and recurrence-free survival.

Conclusion

In patients with clinical stage I lung adenocarcinoma with a C/T ratio ≤0.5 and/or SCL ≤10 mm on TSCT, surgery is extremely likely to achieve a cure.

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Authors and Affiliations

  1. Division of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Shigeki Suzuki, Keiju Aokage, Junji Yoshida, Yuki Matsumura, Tomohiro Haruki, Tomoyuki Hishida & Kanji Nagai

  2. Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan

    Genichiro Ishii

Authors
  1. Shigeki Suzuki
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  2. Keiju Aokage
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  3. Junji Yoshida
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  4. Genichiro Ishii
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  5. Yuki Matsumura
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  6. Tomohiro Haruki
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  7. Tomoyuki Hishida
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  8. Kanji Nagai
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Corresponding author

Correspondence to Keiju Aokage.

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The authors declare that they have no conflicts of interest.

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Suzuki, S., Aokage, K., Yoshida, J. et al. Thin-section computed tomography findings of lung adenocarcinoma with inherent metastatic potential. Surg Today 47, 619–626 (2017). https://doi.org/10.1007/s00595-016-1416-3

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  • DOI: https://doi.org/10.1007/s00595-016-1416-3

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