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Erschienen in:
01.02.2015 | Chest
Pulmonary adenocarcinomas appearing as part-solid ground-glass nodules: Is measuring solid component size a better prognostic indicator?
Erschienen in: European Radiology | Ausgabe 2/2015
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Objective
To assess whether measuring the solid portion of adenocarcinomas appearing as part-solid ground-glass nodules (GGNs) can predict a patient’s prognosis accurately and how the prognosis corresponds to that of solid nodules.
Methods
501 patients (solid nodule group, 304; part-solid GGN group, 197) underwent curative surgery for stage I adenocarcinomas. Maximal diameters of the whole lesion including ground-glass opacities (D
whole
) and solid components only (D
solid
) were measured on CT. Disease-free survival (DFS) and overall survival (OS) were calculated from the date of surgery.
Results
D
solid
was a significant prognostic factor in the part-solid GGN group, while D
whole
was not. Part-solid GGNs with D
solid
≤2 cm showed significantly better DFS (P = 0.016) and OS (P = 0.004) than solid nodules; however, those with D
solid
>2 cm did not show a significant difference. Hazard ratio (HR) for increase in D
solid
was significantly greater in part-solid GGNs than in solid nodules (P = 0.009). For OS, HR for increase in D
solid
was greater in part-solid GGNs than in solid nodule, which was marginally not significant (P = 0.060).
Conclusion
D
solid
was better than D
whole
for prognosis prediction of adenocarcinomas appearing as part-solid GGNs. In addition, the influence of D
solid
on prognosis in the part-solid GGN group was greater than in the solid nodule group.
Key points
• Dsolid
is a better prognosis indicator than Dsolid
in part-solid GGN adenocarcinomas
• Part-solid GGN adenocarcinoma show better prognosis than solid adenocarcinomas when Dsolid
≤2 cm
• Dsolid
has greater prognostic influence in part-solid GGN adenocarcinomas than solid adenocarcinomas