title: Pit-fall sign on computed tomography predicts pleural involvement and poor prognosis in non-small cell lung cancer.
abstract: Pleural involvement by a peripheral non-small cell lung cancer (NSCLC) is an important prognostic factor, but the accurate preoperative evaluation is sometimes difficult. We have already identified a feature on computed tomography (CT) that suggests a possible pleural involvement (pit-fall sign, i.e. multiple linear strands between the nodule and chest wall and/or inter-lobar fissure), and the clinical impact was assessed in the present study. A total of 103 consecutive peripheral NSCLC patients were prospectively examined, and the sensitivity, specificity, and accuracy of pit-fall sign in the diagnosis of pleural involvement were 83.3, 76.1, and 78.6%, respectively. The 5-year survival rate of pit-fall sign-positive patients was 46.5%, which was significantly lower than that of pit-fall sign-negative patients (68.9%; P = 0.044), and the prognostic significance was confirmed by a multivariate analysis. In conclusion, the pit-fall sign on preoperative CT suggests a possible pleural involvement correlated with a poor prognosis.
authors.affiliation: Department of Thoracic Surgery, Faculty of Medicine, Kyoto University, Shogoin-kawahara-cho 54, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Li
authors.forename: Harumi
authors.initials: H
authors.lastname: Ito
authors.forename: Hiromi
authors.initials: H
authors.lastname: Wada
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed