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Prognostic Significance of Ground-Glass Opacity Components in 5-Year Survivors With Resected Lung Adenocarcinoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Reports on the prognosis for 5-year survivors with lung adenocarcinoma after resection are sparse. This study aimed to identify factors associated with overall survival (OS) and cancer-specific survival (CSS) for 5-year survivors with completely resected lung adenocarcinoma, and to determine whether preoperative imaging factors, including the presence of ground-glass opacity (GGO) components, affect late recurrence in long-term survivors.

Methods

Complete resection of lung adenocarcinoma was performed for 1681 patients between January 2000 and December 2013. Of these patients, 936 who survived 5 years or longer after surgery were identified, and factors associated with OS and CSS were determined using the Cox proportional hazard model.

Results

Multivariable analysis demonstrated that lymph node metastasis (p < 0.01) and absence of GGO components (p < 0.01) were independently associated with OS and CSS for the 5-year survivors. The absence of GGO components was significantly associated with OS (p < 0.01) and CSS (p < 0.01) also for the 5-year survivors with stage 1 disease (n = 782) and for the 5-year survivors without recurrence (n = 809). The incidence of recurrence anytime during the 10-year postoperative follow-up period differed significantly between the 5-year survivors with and without GGO components.

Conclusions

The absence of GGO components was significantly associated with an unfavorable prognosis for the 5-year survivors with completely resected lung adenocarcinoma regardless whether they had recurrences not.

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References

  1. Houston KA, Mitchell KA, King J, White A, Ryan BM. Histologic lung cancer incidence rates and trends vary by race/ethnicity and residential county. J Thorac Oncol. 2018;13:497–509.

    Article  Google Scholar 

  2. 2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7–34.

    Article  Google Scholar 

  3. Rami-Porta R, Bolejack V, Crowley J, et al. The IASLC Lung Cancer Staging Project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol. 2015;10:990–1003.

  4. Hattori A, Matsunaga T, Takamochi K, Oh S, Suzuki K. Prognostic impact of a ground-glass opacity component in the clinical T classification of non-small cell lung cancer. J Thorac Cardiovasc Surg. 2017;154:2102–2110.e2101.

    Google Scholar 

  5. Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg. 2013;146:24–30.

    Article  Google Scholar 

  6. Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical IA lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol. 2011;6:751–6.

    Article  Google Scholar 

  7. 7. Ye T, Deng L, Wang S, et al. Lung adenocarcinomas manifesting as radiological part-solid nodules define a special clinical subtype. J Thorac Oncol. 2019;14:617–27.

    Article  Google Scholar 

  8. Miyoshi T, Aokage K, Katsumata S, Tane K, Ishii G, Tsuboi M. Ground-glass opacity is a strong prognosticator for pathologic stage IA lung adenocarcinoma. Ann Thorac Surg. 2019;108:249–55.

    Article  Google Scholar 

  9. Aokage K, Miyoshi T, Ishii G, et al. Influence of Ground-glass opacity and the corresponding pathological findings on survival in patients with clinical stage I non-small cell lung cancer. J Thorac Oncol. 2018;13:533–42.

    Article  Google Scholar 

  10. Noguchi M, Morikawa A, Kawasaki M, et al. Small adenocarcinoma of the lung: histologic characteristics and prognosis. Cancer. 1995;75:2844–52.

    Article  CAS  Google Scholar 

  11. Okiror L, Harling L, Toufektzian L, et al. Prognostic factors including lymphovascular invasion on survival for resected non-small cell lung cancer. J Thorac Cardiovasc Surg. 2018;156:785–93.

    Article  Google Scholar 

  12. Matsumura Y, Hishida T, Shimada Y, et al. Impact of extratumoral lymphatic permeation on postoperative survival of non-small cell lung cancer patients. J Thorac Oncol. 2014;9:337–44.

    Article  CAS  Google Scholar 

  13. Kudo Y, Saji H, Shimada Y, et al. Impact of visceral pleural invasion on the survival of patients with non-small cell lung cancer. Lung Cancer. 2012;78:153–60.

    Article  Google Scholar 

  14. Shimada Y, Saji H, Yoshida K, et al. Pathological vascular invasion and tumor differentiation predict cancer recurrence in stage IA non-small-cell lung cancer after complete surgical resection. J Thorac Oncol. 2012;7:1263–70.

    Article  Google Scholar 

  15. Agarwal M, Brahmanday G, Chmielewski GW, Welsh RJ, Ravikrishnan KP. Age, tumor size, type of surgery, and gender predict survival in early stage (stage I and II) non-small cell lung cancer after surgical resection. Lung Cancer. 2010;68:398–402.

    Article  Google Scholar 

  16. Kawai H, Tada A, Kawahara M, et al. Smoking history before surgery and prognosis in patients with stage IA non-small-cell lung cancer: a multicenter study. Lung Cancer. 2005;49:63–70.

    Article  Google Scholar 

  17. Asamura H, Chansky K, Crowley J, et al. The International Association for the Study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer. J Thorac Oncol. 2015;10:1675–84.

  18. Maeda R, Yoshida J, Ishii G, Hishida T, Nishimura M, Nagai K. Prognostic impact of intratumoral vascular invasion in non-small cell lung cancer patients. Thorax. 2010;65:1092–8.

    Article  Google Scholar 

  19. Martini N, Rusch VW, Bains MS, et al. Factors influencing ten-year survival in resected stages I to IIIa non-small cell lung cancer. J Thorac Cardiovasc Surg. 1999;117:32–6; discussion 37–8.

  20. Okada M, Nishio W, Sakamoto T, Harada H, Uchino K, Tsubota N. Long-term survival and prognostic factors of five-year survivors with complete resection of non-small cell lung carcinoma. J Thorac Cardiovasc Surg. 2003;126:558–62.

    Article  Google Scholar 

  21. Maeda R, Yoshida J, Hishida T, et al. Late recurrence of non-small cell lung cancer more than 5 years after complete resection: incidence and clinical implications in patient follow-up. Chest. 2010;138:145–50.

    Article  Google Scholar 

  22. Martini N, Melamed MR. Multiple primary lung cancers. J Thorac Cardiovasc Surg. 1975;70:606–12.

    Article  CAS  Google Scholar 

  23. Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical, and radiologic advances since the 2004 classification. J Thorac Oncol. 2015;10:1243–60.

    Article  Google Scholar 

  24. Sobin LH, Gospodarowicz MK, Wittekind Ch, (Eds.) TNM Classification of Malignant Tumours. 7th ed. England: Wiley-Blackwell; 2009.

  25. Lou F, Huang J, Sima CS, Dycoco J, Rusch V, Bach PB. Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance. J Thorac Cardiovasc Surg. 2013;145:75–81 (discussion 81–2).

  26. Kodama K, Higashiyama M, Yokouchi H, et al. Prognostic value of ground-glass opacity found in small lung adenocarcinoma on high-resolution CT scanning. Lung Cancer. 2001;33:17–25.

    Article  CAS  Google Scholar 

  27. Aoki T, Tomoda Y, Watanabe H, et al. Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival. Radiology. 2001;220:803–9.

    Article  CAS  Google Scholar 

  28. Russell PA, Wainer Z, Wright GM, Daniels M, Conron M, Williams RA. Does lung adenocarcinoma subtype predict patient survival? A clinicopathologic study based on the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary lung adenocarcinoma classification. J Thorac Oncol. 2011;6:1496–504.

    Article  Google Scholar 

  29. Ohtaki Y, Yoshida J, Ishii G, et al. Prognostic significance of a solid component in pulmonary adenocarcinoma. Ann Thorac Surg. 2011;91:1051–7.

    Article  Google Scholar 

  30. Yatabe Y, Borczuk AC, Powell CA. Do all lung adenocarcinomas follow a stepwise progression? Lung Cancer. 2011;74:7–11.

    Article  Google Scholar 

  31. Suda K, Shimoji M, Shimizu S, et al. Comparison of PD-L1 expression status between pure-solid versus part-solid lung adenocarcinomas. Biomolecules. 2019;9:456.

  32. Schmidt-Kittler O, Ragg T, Daskalakis A, et al. From latent disseminated cells to overt metastasis: genetic analysis of systemic breast cancer progression. Proc Natl Acad Sci U S A. 2003;100:7737–42.

    Article  CAS  Google Scholar 

  33. Weckermann D, Müller P, Wawroschek F, Harzmann R, Riethmüller G, Schlimok G. Disseminated cytokeratin positive tumor cells in the bone marrow of patients with prostate cancer: detection and prognostic value. J Urol. 2001;166:699–703.

    Article  CAS  Google Scholar 

  34. Neophytou CM, Kyriakou TC, Papageorgis P. Mechanisms of metastatic tumor dormancy and implications for cancer therapy. Int J Mol Sci. 2019;20:6158.

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Acknowledgements

The authors are indebted to the medical editors from the Department of International Medical Communications of Tokyo Medical University for editing of the English manuscript. We also thank Mami Murakami for assistance with the statistical analyses in this study.

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Authors and Affiliations

  1. Department of Surgery, Tokyo Medical University, Tokyo, Japan

    Shunsuke Shigefuku MD, PhD, Yoshihisa Shimada MD, PhD, Masaru Hagiwara MD, PhD, Masatoshi Kakihana MD, PhD, Naohiro Kajiwara MD, PhD, Tatsuo Ohira MD, PhD & Norihiko Ikeda MD, PhD

Authors
  1. Shunsuke Shigefuku MD, PhD
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  2. Yoshihisa Shimada MD, PhD
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  3. Masaru Hagiwara MD, PhD
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  4. Masatoshi Kakihana MD, PhD
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  5. Naohiro Kajiwara MD, PhD
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  6. Tatsuo Ohira MD, PhD
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  7. Norihiko Ikeda MD, PhD
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Corresponding author

Correspondence to Yoshihisa Shimada MD, PhD.

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Disclosures

Norihiko Ikeda received grants and honoraria from AstraZeneca, Chugai, Boehringer-Ingelheim Japan, Pfizer, Taiho, Eli Lilly Japan, Ono, Bristol-Myers Squibb, MSD, Teijin and Nihon Medi-physics, as well as grants from Kyowa Kirin, Sanofi, Eisai, Astellas, Shionogi, Daiichi-Sankyo, and Roche Diagnostics, and honoraria from Olympus, Johnson and Johnson, and Medtronic.

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Supplementary material 1 (DOCX 23 kb)

10434_2020_9125_MOESM2_ESM.tiff

Comparison between a type of recurrence and b initial recurrence sites according to the elapsed time after resection (≤ 5 vs > 5 years) for the 5-year survivors who had resected lung adenocarcinoma with the presence (+) or absence (−) of ground-glass opacity (GGO) components. a For the patients with recurrent disease arising within 5 years after resection, the rates for local and distant recurrences showed significant differences between those with GGO components and those without GGO components. Conversely, for the patients in the late recurrence group, only the local recurrence rate showed a significant difference between those with GGO components and those without GGO components. b For the initial sites of recurrence, the local recurrence rates for the patients with GGO components were higher than for those without GGO components regardless of the elapsed time after surgery. (TIFF 47797 kb)

Supplementary material 3 (TIFF 46241 kb)

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Shigefuku, S., Shimada, Y., Hagiwara, M. et al. Prognostic Significance of Ground-Glass Opacity Components in 5-Year Survivors With Resected Lung Adenocarcinoma. Ann Surg Oncol 28, 148–156 (2021). https://doi.org/10.1245/s10434-020-09125-x

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  • DOI: https://doi.org/10.1245/s10434-020-09125-x

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