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23.08.2017 | Computed Tomography

Controversies on lung cancers manifesting as part-solid nodules

verfasst von: Rowena Yip, Kunwei Li, Li Liu, Dongming Xu, Kathleen Tam, David F. Yankelevitz, Emanuela Taioli, Betsy Becker, Claudia I. Henschke

Erschienen in: European Radiology | Ausgabe 2/2018

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Abstract

Purpose

Summarise survival of patients with resected lung cancers manifesting as part-solid nodules (PSNs).

Methods

PubMed/MEDLINE and EMBASE databases were searched for all studies/clinical trials on CT-detected lung cancer in English before 21 December 2015 to identify surgically resected lung cancers manifesting as PSNs. Outcome measures were lung cancer-specific survival (LCS), overall survival (OS), or disease-free survival (DFS). All PSNs were classified by the percentage of solid component to the entire nodule diameter into category PSNs <80% or category PSNs ≥80%.

Results

Twenty studies reported on PSNs <80%: 7 reported DFS and 2 OS of 100%, 6 DFS 96.3-98.7%, and 11 OS 94.7-98.9% (median DFS 100% and OS 97.5%). Twenty-seven studies reported on PSNs ≥80%: 1 DFS and 2 OS of 100%, 19 DFS 48.0%-98.0% (median 82.6%), and 16 reported OS 43.0%-98.0% (median DFS 82.6%, OS 85.5%). Both DFS and OS were always higher for PSNs <80%.

Conclusion

A clear definition of the upper limit of solid component of a PSN is needed to avoid misclassification because cell-types and outcomes are different for PSN and solid nodules. The workup should be based on the size of the solid component.

Key points

• Lung cancers manifesting as PSNs are slow growing with high cure rates.

• Upper limits of the solid component are important for correct interpretation.

• Consensus definition is important for the management of PSNs.

• Median disease-free-survival (DFS) increased with decreasing size of the nodule.

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Titel: Controversies on lung cancers manifesting as part-solid nodules
verfasst von: Rowena Yip
Kunwei Li
Li Liu
Dongming Xu
Kathleen Tam
David F. Yankelevitz
Emanuela Taioli
Betsy Becker
Claudia I. Henschke
Publikationsdatum: 23.08.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4975-9

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Controversies on lung cancers manifesting as part-solid nodules

Abstract

Purpose

Methods

Results

Conclusion

Key points

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