Prognostic Analysis of Stage I Non-Small Cell Lung Cancer Abutting Adjacent Structures on Preoperative Computed Tomography

被引:0
作者
Choi, Soohwan [1 ,2 ]
Ro, Sun Kyun [2 ]
Moon, Seok Whan [1 ]
机构
[1] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Thorac & Cardiovasc Surg, Seoul, South Korea
[2] Hanyang Univ, Guri Hosp, Coll Med, Dept Thorac & Cardiovasc Surg, Guri, South Korea
来源
JOURNAL OF CHEST SURGERY | 2024年 / 57卷 / 02期
关键词
Abutting; Non-small-cell lung carcinoma; Visceral pleural invasion; Disease- free survival; VISCERAL PLEURAL INVASION; ADJUVANT CHEMOTHERAPY; SURVIVAL;
D O I
10.5090/jcs.23.153
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Early non-small cell lung cancer (NSCLC) that abuts adjacent structures requires careful evaluation due to its potential impact on postoperative outcomes and prognosis. We examined stage I NSCLC with invasion into adjacent structures, focusing on the prognostic implications after curative surgical resection. Methods: We retrospectively analyzed the records of 796 patients who underwent curative surgical resection for pathologic stage IA/IB NSCLC (i.e., visceral pleural invasion only) at a single center from 2008 to 2017. Patients were classified based on tumor abutment and then reclassified by the presence of visceral pleural invasion. Clinical characteristics, pathological features, and survival rates were compared. Results: The study included 181 patients with abutting NSCLC (22.7% of all participants) and 615 with non-abutting tumors (77.3%). Those with tumor abutment exhibited higher rates of non-adenocarcinoma (26.5% vs. 9.9%, p<0.01) and visceral/lymphatic/vascular invasion (30.4%/33.1%/12.7% vs. 8.5%/22.4%/5.7%, respectively; p<0.01) compared to those without abutment. Multivariable analysis identified lymphatic invasion and male sex as risk factors for overall survival (OS) and disease-free survival (DFS) in stage I NSCLC measuring 3 cm or smaller. Age, smoking history, vascular invasion, and recurrence emerged as risk factors for OS, whereas the presence of non-pure ground-glass opacity was a risk factor for DFS. Conclusion: NSCLC lesions 3 cm or smaller that abut adjacent structures present higher rates of various riskfactors than non-abutting lesions, necessitating evaluation of tumor invasion into adjacent structures and lymph node metastasis. In isolation, however, the presence of tumor abutment without visceral pleural invasion does not constitute a risk factor.
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收藏
页码:136 / 144
页数:9
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