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Pulmonary adenocarcinomas appearing as part-solid ground-glass nodules: Is measuring solid component size a better prognostic indicator?

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Abstract

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

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Abbreviations

GGN:

Ground-glass nodule

D whole :

Maximal diameter of the whole lesion including ground-glass opacity

D solid :

Maximal diameter of solid component only

DFS:

Disease-free survival

OS:

Overall survival

HR:

Hazard ratio

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Acknowledgements

The scientific guarantor of this publication is Chang Min Park, MD, PhD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study received funding from the Research Grant of the Korean Foundation for Cancer Research (grant number: CB-2011-02-01). The Medical Research Collaborating Center in Seoul National University Hospital kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Some study subjects or cohorts have been previously reported in Lee SM, Park CM, Goo JM, Lee HJ, Wi JY, Kang CH (2013) Invasive pulmonary adenocarcinomas versus preinvasive lesions appearing as ground-glass nodules: differentiation by using CT features. Radiology 268:265-273. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, , Jongno-gu,, Seoul, 110-744, Korea

    Eui Jin Hwang, Chang Min Park, Youngjin Ryu, Sang Min Lee & Jin Mo Goo

  2. Cancer Research Institute, Seoul National University, Seoul, Korea

    Chang Min Park, Young Tae Kim & Jin Mo Goo

  3. Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea

    Young Tae Kim

  4. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea

    Young Whan Kim

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  1. Eui Jin Hwang
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Correspondence to Chang Min Park.

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Hwang, E.J., Park, C.M., Ryu, Y. et al. Pulmonary adenocarcinomas appearing as part-solid ground-glass nodules: Is measuring solid component size a better prognostic indicator?. Eur Radiol 25, 558–567 (2015). https://doi.org/10.1007/s00330-014-3441-1

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  • DOI: https://doi.org/10.1007/s00330-014-3441-1

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