Abstract
BackgroundRecently, several reports investigating tumor doubling times (TDTs) in lung cancer have demonstrated that lung cancer patients with shorter TDTs have poor prognoses. Although data have shown that the solid component of a tumor is clinically more important, relationships between solid component TDTs and lung cancer prognoses remain unclear.MethodsTo evaluate relationships between TDT and survival, we retrospectively evaluated 231 patients who underwent surgical resection for non-small cell lung cancer. The TDTs of whole and solid components were calculated using preoperative thin-slice chest computed tomography scans with a cut-off of 400 d between scans.ResultsPatients with short TDTs (< 400 d) both in the solid and whole components had poor prognoses. Among pathological stage I patients (n = 176), short solid component TDT (< 400 d) significantly influenced prognosis only in pathological stage IB patients. Moreover, we found that patients with shorter solid component TDTs had significantly worse prognosis compared with patients who showed shorter whole component TDTs.ConclusionsShort solid component TDTs (< 400 d) could be a poor prognostic indicator for non-small cell lung cancer patients undergoing surgical resection; furthermore, clinicians should pay particularly close attention to cases with rapid growth of the solid tumor component.
Highlights
Several reports investigating tumor doubling times (TDTs) in lung cancer have demonstrated that lung cancer patients with shorter TDTs have poor prognoses
Clinical characteristics of all patients and patients divided by TDT We measured maximum tumor diameters and the largest perpendicular tumor diameters of whole tumors and the solid components to subsequently calculate TDTs for solid components and whole tumors using the Schwartz formula (Fig. 1)
Clinical characteristics of pathological stages IA1, IA2, IA3 and IB divided by TDT we evaluated whether solid component TDT influenced pathological stage I cases (IA1, IA2, IA3 and IB), as the solid component has become more important for stage I patients in the 8th edition of the American Joint Committee for Cancer Staging System
Summary
Several reports investigating tumor doubling times (TDTs) in lung cancer have demonstrated that lung cancer patients with shorter TDTs have poor prognoses. There have been several reports focused on the tumor doubling time (TDT) of lung cancer [1,2,3,4,5,6,7]. These studies have found relationships between TDT and lung cancer prognosis using chest radiograph and computed tomography (CT) scans: longer TDT is associated with better prognosis. There have been no reports regarding relationships between solid component TDT and prognosis in surgically resected non-small cell lung cancer (NSCLC) patients; there are no reports of using TDT as
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