Cargando…
Prognostic Significance of Tumor Size of Small Lung Adenocarcinomas Evaluated with Mediastinal Window Settings on Computed Tomography
BACKGROUND: We aimed to clarify that the size of the lung adenocarcinoma evaluated using mediastinal window on computed tomography is an important and useful modality for predicting invasiveness, lymph node metastasis and prognosis in small adenocarcinoma. METHODS: We evaluated 176 patients with sma...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217725/ https://www.ncbi.nlm.nih.gov/pubmed/25365326 http://dx.doi.org/10.1371/journal.pone.0110305 |
_version_ | 1782342433790492672 |
---|---|
author | Sakao, Yukinori Kuroda, Hiroaki Mun, Mingyon Uehara, Hirofumi Motoi, Noriko Ishikawa, Yuichi Nakagawa, Ken Okumura, Sakae |
author_facet | Sakao, Yukinori Kuroda, Hiroaki Mun, Mingyon Uehara, Hirofumi Motoi, Noriko Ishikawa, Yuichi Nakagawa, Ken Okumura, Sakae |
author_sort | Sakao, Yukinori |
collection | PubMed |
description | BACKGROUND: We aimed to clarify that the size of the lung adenocarcinoma evaluated using mediastinal window on computed tomography is an important and useful modality for predicting invasiveness, lymph node metastasis and prognosis in small adenocarcinoma. METHODS: We evaluated 176 patients with small lung adenocarcinomas (diameter, 1–3 cm) who underwent standard surgical resection. Tumours were examined using computed tomography with thin section conditions (1.25 mm thick on high-resolution computed tomography) with tumour dimensions evaluated under two settings: lung window and mediastinal window. We also determined the patient age, gender, preoperative nodal status, tumour size, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and pathological status (lymphatic vessel, vascular vessel or pleural invasion). Recurrence-free survival was used for prognosis. RESULTS: Lung window, mediastinal window, tumour disappearance ratio and preoperative nodal status were significant predictive factors for recurrence-free survival in univariate analyses. Areas under the receiver operator curves for recurrence were 0.76, 0.73 and 0.65 for mediastinal window, tumour disappearance ratio and lung window, respectively. Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant predictive factors for lymph node metastasis in univariate analyses; areas under the receiver operator curves were 0.61, 0.76, 0.72 and 0.66, for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively. Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant factors for lymphatic vessel, vascular vessel or pleural invasion in univariate analyses; areas under the receiver operator curves were 0.60, 0.81, 0.81 and 0.65 for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively. CONCLUSIONS: According to the univariate analyses including a logistic regression and ROCs performed for variables with p-values of <0.05 on univariate analyses, our results suggest that measuring tumour size using mediastinal window on high-resolution computed tomography is a simple and useful preoperative prognosis modality in small adenocarcinoma. |
format | Online Article Text |
id | pubmed-4217725 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-42177252014-11-05 Prognostic Significance of Tumor Size of Small Lung Adenocarcinomas Evaluated with Mediastinal Window Settings on Computed Tomography Sakao, Yukinori Kuroda, Hiroaki Mun, Mingyon Uehara, Hirofumi Motoi, Noriko Ishikawa, Yuichi Nakagawa, Ken Okumura, Sakae PLoS One Research Article BACKGROUND: We aimed to clarify that the size of the lung adenocarcinoma evaluated using mediastinal window on computed tomography is an important and useful modality for predicting invasiveness, lymph node metastasis and prognosis in small adenocarcinoma. METHODS: We evaluated 176 patients with small lung adenocarcinomas (diameter, 1–3 cm) who underwent standard surgical resection. Tumours were examined using computed tomography with thin section conditions (1.25 mm thick on high-resolution computed tomography) with tumour dimensions evaluated under two settings: lung window and mediastinal window. We also determined the patient age, gender, preoperative nodal status, tumour size, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and pathological status (lymphatic vessel, vascular vessel or pleural invasion). Recurrence-free survival was used for prognosis. RESULTS: Lung window, mediastinal window, tumour disappearance ratio and preoperative nodal status were significant predictive factors for recurrence-free survival in univariate analyses. Areas under the receiver operator curves for recurrence were 0.76, 0.73 and 0.65 for mediastinal window, tumour disappearance ratio and lung window, respectively. Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant predictive factors for lymph node metastasis in univariate analyses; areas under the receiver operator curves were 0.61, 0.76, 0.72 and 0.66, for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively. Lung window, mediastinal window, tumour disappearance ratio, preoperative serum carcinoembryonic antigen levels and preoperative nodal status were significant factors for lymphatic vessel, vascular vessel or pleural invasion in univariate analyses; areas under the receiver operator curves were 0.60, 0.81, 0.81 and 0.65 for lung window, mediastinal window, tumour disappearance ratio and preoperative serum carcinoembryonic antigen levels, respectively. CONCLUSIONS: According to the univariate analyses including a logistic regression and ROCs performed for variables with p-values of <0.05 on univariate analyses, our results suggest that measuring tumour size using mediastinal window on high-resolution computed tomography is a simple and useful preoperative prognosis modality in small adenocarcinoma. Public Library of Science 2014-11-03 /pmc/articles/PMC4217725/ /pubmed/25365326 http://dx.doi.org/10.1371/journal.pone.0110305 Text en © 2014 Sakao et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Sakao, Yukinori Kuroda, Hiroaki Mun, Mingyon Uehara, Hirofumi Motoi, Noriko Ishikawa, Yuichi Nakagawa, Ken Okumura, Sakae Prognostic Significance of Tumor Size of Small Lung Adenocarcinomas Evaluated with Mediastinal Window Settings on Computed Tomography |
title | Prognostic Significance of Tumor Size of Small Lung Adenocarcinomas Evaluated with Mediastinal Window Settings on Computed Tomography |
title_full | Prognostic Significance of Tumor Size of Small Lung Adenocarcinomas Evaluated with Mediastinal Window Settings on Computed Tomography |
title_fullStr | Prognostic Significance of Tumor Size of Small Lung Adenocarcinomas Evaluated with Mediastinal Window Settings on Computed Tomography |
title_full_unstemmed | Prognostic Significance of Tumor Size of Small Lung Adenocarcinomas Evaluated with Mediastinal Window Settings on Computed Tomography |
title_short | Prognostic Significance of Tumor Size of Small Lung Adenocarcinomas Evaluated with Mediastinal Window Settings on Computed Tomography |
title_sort | prognostic significance of tumor size of small lung adenocarcinomas evaluated with mediastinal window settings on computed tomography |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217725/ https://www.ncbi.nlm.nih.gov/pubmed/25365326 http://dx.doi.org/10.1371/journal.pone.0110305 |
work_keys_str_mv | AT sakaoyukinori prognosticsignificanceoftumorsizeofsmalllungadenocarcinomasevaluatedwithmediastinalwindowsettingsoncomputedtomography AT kurodahiroaki prognosticsignificanceoftumorsizeofsmalllungadenocarcinomasevaluatedwithmediastinalwindowsettingsoncomputedtomography AT munmingyon prognosticsignificanceoftumorsizeofsmalllungadenocarcinomasevaluatedwithmediastinalwindowsettingsoncomputedtomography AT ueharahirofumi prognosticsignificanceoftumorsizeofsmalllungadenocarcinomasevaluatedwithmediastinalwindowsettingsoncomputedtomography AT motoinoriko prognosticsignificanceoftumorsizeofsmalllungadenocarcinomasevaluatedwithmediastinalwindowsettingsoncomputedtomography AT ishikawayuichi prognosticsignificanceoftumorsizeofsmalllungadenocarcinomasevaluatedwithmediastinalwindowsettingsoncomputedtomography AT nakagawaken prognosticsignificanceoftumorsizeofsmalllungadenocarcinomasevaluatedwithmediastinalwindowsettingsoncomputedtomography AT okumurasakae prognosticsignificanceoftumorsizeofsmalllungadenocarcinomasevaluatedwithmediastinalwindowsettingsoncomputedtomography |