Tumor size, but not consolidation‐to‐tumor ratio, is an independent prognostic factor for part‐solid clinical T1 non‐small cell lung cancer

Abstract

Background Tumor size and consolidation‐to‐tumor ratio (CTR) are crucial for non–small cell lung cancer (NSCLC) prognosis. However, the optimal CTR cutoff remains unclear. Whether tumor size and CTR are independent prognostic factors for part‐solid NSCLC is under debate. Here, we aimed to evaluate the prognostic impacts of CTR and tumor size on NSCLC, especially on part‐solid NSCLC. Methods We reviewed 1366 clinical T1 NSCLC patients who underwent surgical treatment. Log‐rank test and Cox regression analyses were adopted for prognostic evaluation. The “surv_cutpoint” function was used to identify the optimal CTR and tumor size cutoff values. Results There were 416, 510, and 440 subjects with pure ground‐glass opacity (pGGO), part‐solid, and pure solid nodules. The 5‐year overall survival (disease‐free survival) for patients with pGGO, part‐solid, and pure solid nodules were 99.5% (99.5%), 97.3% (95.8%), and 90.4% (78.9%), respectively. Multivariate Cox regression analysis indicated that CTR was an independent prognostic factor for the whole patients, and the optimal CTR cutoff was 0.99. However, for part‐solid NSCLC, CTR was not independently associated with survival, even if categorized by the optimal cutoffs. The predicted optimal cutoffs of total tumor size and solid component size were 2.4 and 1.4 cm for part‐solid NSCLC. Total tumor size (HR = 6.21, 95% CI: 1.58–24.34, p = 0.009) and solid component size (HR = 2.27, 95% CI: 1.04–5.92, p = 0.045) grouped by the cutoffs were significantly associated with part‐solid NSCLC prognosis. Conclusions CTR was an independent prognostic factor for the whole NSCLC, but not for the part‐solid NSCLC. Tumor size was still meaningful for part‐solid NSCLC.

Segmentectomy versus lobectomy for small‐sized pure solid non–small cell lung cancer

“…3 Similarly, Isaka et al 22 reported that segmentectomy reached a higher 5-year OS than lobectomy for stage 0-I lung cancer with high comorbidities, but not for those with low comorbidities. NSCLC with pure solid nodules usually had older age, a higher smoking rate, and a higher proportion of SCC and other histologic subtypes than those with GGO component 6,23,24 Whether segmentectomy could achieve a better OS than lobectomy for pure solid NSCLC with poor conditions needed more studies.…”

Preoperative systemic immune-inflammation index-based nomogram for lung carcinoma following microwave ablation -a real world single center study

“…Furthermore, our research revealed another significant factor affecting the prognosis of MWA patients is the size of the tumor. Clinically, the maximum diameter of the primary tumor plays a pivotal role in tumor TNM staging and has been affirmed as an independent prognostic factor in several studies concerning lung carcinoma ( 38 , 39 ). Simultaneously, larger-diameter tumors exhibit a significantly higher rate of recurrence after thermal ablation.…”

A rare case report: co-occurrence of two types of lung cancer with hamartoma and pulmonary tuberculosis

“…acknowledged that the CTR was an independent prognostic factor for the entire non-small cell lung cancer (NSCLC) population, but not for certain subtypes of NSCLC. Tumor size still holds significance for certain solid NSCLC cases ( 11 ). Hence, in clinical practice, even for pure ground-glass nodules (GGNs) detected on CT, it is important to consider multiple factors such as tumor diameter, serum tumor markers, maximum standardized uptake value on PET-CT, age, gender, smoking status, current extra-pulmonary cancer, air bronchogram and nodule size (p<0.05),circulating tumor cell,and others ( 12 , 13 ).…”