Prognostic significance of high-resolution CT findings in small peripheral adenocarcinoma of the lung: a retrospective study on 64 patients

Abstract

Objective: We studied the prognostic importance of high-resolution CT (HRCT) findings in lung adenocarcinomas. Patients and methods: HRCT findings (lesion size, percentage of ground-glass opacity (GGO) areas of lesion, and presence or absence of lobulation, coarse spiculation, air space, pleural tag, and multiplicity of lesion), clinical data (age and surgical method), and pathologic findings (tumor subtypes and presence or absence of nodal metastasis) in 64 consecutive patients with 64 peripheral adenocarcinomas of 20 mm or less (mean, 13 mm), including 36 women and 28 men with a mean age of 64 years were analyzed and correlated with survival of the patients using Kaplan–Meier method and stepwise Cox proportional hazards modeling. Follow-up periods of the patients ranged from 6 to 45 months (mean, 22 months). Tumors were classified into six subtypes (types A–F) according to tumor growth patterns defined by Noguchi et al. Results: Six (9%) of the 64 patients died of lung cancer. In univariate analyses, a significant difference was noted for lesion size ( P=0.043), the percentage of GGO areas ( P=0.005), and tumor subtypes ( P=0.006). Lesion size of <15 mm ( n=35), a lesion with GGO areas of >57% ( n=36), and type A ( n=16) or type B adenocarcinomas ( n=16) indicated a significantly better survival. In multivariate analyses using these three parameters as independent variables, the percentage of GGO areas was the only significant independent factor for survival ( P=0.044, relative risk=0.95). Conclusion: GGO areas measured on HRCT may have an independent prognostic significance of small adenocarcinomas of the lung.