Thoracic: Lung Cancer
Clinical impact of a small component of ground-glass opacity in solid-dominant clinical stage IA non–small cell lung cancer

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Abstract

Objective

Non–small cell lung cancers with a ground-glass opacity component have better prognosis than those with solid nodules of equivalent consolidation size. However, the impact of small ground-glass opacity components on prognosis is unknown. Therefore, we aimed to evaluate the significance of a small ground-glass opacity component in solid-dominant clinical stage IA non–small cell lung cancers.

Methods

We reviewed the cases of 543 surgically resected solid-dominant c-stage IA non–small cell lung cancers, which was defined as a tumor with consolidation tumor ratio of 0.75 or more on computed tomography. The patients were classified into 2 groups: 0.75 or less consolidation tumor ratio less than 1 (n = 126) and consolidation tumor ratio of 1 (n = 417). The prognoses were compared between the 2 groups.

Results

Among the 543 cases, multivariable analyses revealed that pure-solid appearance was a predictor of worse overall survival (hazard ratio, 2.051; 95% confidence interval, 1.044-4.028). Compared with the part-solid group, the pure-solid group was associated with poor survival in c-stages IA2 (5-year overall survival: 91.5% vs 76.8%, hazard ratio, 2.942; 95% confidence interval, 1.402-6.173; recurrence-free survival: 89.0% vs 68.8%, hazard ratio, 3.439; 95% confidence interval, 1.776-6.669) and IA3 (5-year overall survival: 93.5% vs 63.0%, hazard ratio, 5.110; 95% confidence interval, 1.607-16.241; recurrence-free survival: 80.5% vs 54.1%, hazard ratio, 2.789; 95% confidence interval, 1.290-6.027). The T categories significantly affected 5-year overall survival only in the pure-solid group (cT1a, 89.3%; cT1b, 76.8%; cT1c, 63.0%).

Conclusions

A small ground-glass opacity component has an impact on the prognosis of patients with solid-dominant c-stage IA non–small cell lung cancer. Therefore, c-stage IA non–small cell lung cancers should be evaluated separately for tumors with ground-glass opacity and pure-solid tumors.

Key Words

clinical stage IA
ground-glass opacity
non–small cell lung cancer
pure solid

Abbreviations and Acronyms

CI
confidence interval
CT
computed tomography
CTR
consolidation tumor ratio
GGO
ground-glass opacity
HR
hazard ratio
NSCLC
non–small cell lung cancer
OS
overall survival
RFS
recurrence-free survival
SUVmax
maximum standardized uptake value

Cited by (0)

This work was supported in by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare, Japan, the Smoking Research Foundation, and the National Cancer Center Research and Development Fund (26-A-4).

Read at the Twenty-sixth European Conference on General Thoracic Surgery, Ljubljana, Slovenia, May 27-30, 2018.