title: Prognostic significance of using solid versus whole tumor size on high-resolution computed tomography for predicting pathologic malignant grade of tumors in clinical stage IA lung adenocarcinoma: a multicenter study.
abstract: OBJECTIVE
  The present multicenter study compared the usefulness of the solid tumor size with that of the whole tumor size on preoperative high-resolution computed tomography for predicting pathologic high-grade malignancy (positive lymphatic, vascular, or pleural invasion) and the prognosis of clinical stage IA lung adenocarcinoma.
  
  
  METHODS
  We performed high-resolution computed tomography and F-18 fluorodeoxyglucose-positron emission tomography/computed tomography before curative surgical resection in 502 patients with clinical stage IA lung adenocarcinoma. The revised maximum standardized uptake values on F-18 fluorodeoxyglucose-positron emission tomography/computed tomography were used to correct interinstitutional discrepancies. The whole and solid tumor sizes on high-resolution computed tomography were then analyzed in relation to surgical results.
  
  
  RESULTS
  The mean whole and solid tumor size was 1.97 ± 0.59 cm and 1.20 ± 0.88 cm, respectively. The receiver operating characteristics area under the curve for the whole and solid tumor sizes used to identify high-grade malignancy were 0.590 and 0.829, respectively. Multiple logistic regression analyses demonstrated solid tumor size (P < .001) and maximum standardized uptake values of the tumor (P < .001) as independent variables for the prediction of high-grade malignancy. Multivariate Cox analysis of disease-free survival demonstrated the former (hazard ratio, 2.30; 95% confidence interval, 1.46-3.63; P < .001) and latter (hazard ratio, 1.08; 95% confidence interval, 1.00-1.17; P = .05) as independent prognostic factors.
  
  
  CONCLUSIONS
  The solid tumor size on high-resolution computed tomography and maximum standardized uptake values on positron emission tomography/computed tomography have greater predictive value for high-grade malignancy and prognosis in clinical stage IA lung adenocarcinoma than that of whole tumor size.
authors: Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
authors: Yasuhiro
authors: Y
authors: Tsutani
authors: Yoshihiro
authors: Y
authors: Miyata
authors: Haruhiko
authors: H
authors: Nakayama
authors: Sakae
authors: S
authors: Okumura
authors: Shuji
authors: S
authors: Adachi
authors: Masahiro
authors: M
authors: Yoshimura
authors: Morihito
authors: M
authors: Okada
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18