Predictors of Pathologic Tumor Invasion and Prognosis for GGO Featured Lung Adenocarcinoma.

Background: We make surgical strategies for ground glass opacity (GGO) nodules currently based on thin-section (TS)-CT findings. Whether radiologic measurements could precisely predict tumor invasion and prognosis of GGO-featured lung adenocarcinoma is uncertain.Methods: We retrospectively evaluated medical records of patients with radiologic GGO nodules receiving surgery at FUSCC. The study endpoints were the predictive value andprognostic significance of radiologic measurements (CTR value, consolidation size and tumor size) for pathologic lung adenocarcinoma. Results: 850 patients and 850 GGO nodules were included. 5-year lung cancer specific - regression free survival (LCS-RFS) rate was 96.43% (95% CI, 94.01-95.42%). 5-year LCS-overall survival (OS) rate was 98.73% (95% CI, 98.74-99.57%). Multivariable analysis showed that tumor invasion (Invasive adenocarcinoma (IAD) vs AIS/MIA, P=0.022) was the only independent predictor for 5-year LCS-RFS. IAD (Hazard Ratio (HR): 15.99; 95% CI: 1.55-167.32) were correlated with a higher risk of recurrence. Kaplan-meier analysis showed that only tumor invasion status (IAD vs AIS/MIA,P=0.005) could predict 5-year LCS-OS, IAD had a worse LCS-OS than AIS and MIA. Part-solid component (OR: 9.11; 95% CI: 2.77-30.47; P=0.000), large consolidation size(OR: 3.14; 95% CI: 1.05-9.40; P=0.049) and large tumor size (OR: 5.48; 95% CI: 2.66- 11.16; P=0.001) were associated with pathologic IAD. For IAD≤20mm, segmentectomyand lobectomy had better 5-year LCS-RFS than wedge resection, though the difference was statistically insignificant (P=0.388). The three types of surgeries provided the similar5-year LCS-OS (P=0.831). Conclusions: Radiologic measurements could not precisely predict tumor invasion and prognosis. Making treatment strategies solely according to TS-CT findings for GGO tumor is inappropriate.

کلیدواژه ها:

Radiologic measurements ، precisely predict tumor invasion ، Lung Adenocarcinoma