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Kenji Suzuki - One of the best experts on this subject based on the ideXlab platform.
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prognostic impact of a Ground Glass Opacity component in the clinical t classification of non small cell lung cancer
The Journal of Thoracic and Cardiovascular Surgery, 2017Co-Authors: Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Kenji SuzukiAbstract:Abstract Objective To determine whether solid component size and the presence of a Ground Glass Opacity (GGO) component are independently associated with survival outcomes in patients with early-stage non–small cell lung cancer (NSCLC) using the eighth edition Lung Cancer Stage Classification. Methods We retrospectively evaluated 1029 surgically resected early-stage NSCLCs. T categories were assigned based on solid component size using the eighth classification. All tumors were classified into 1 of 2 groups: the GGO group or the solid group. We evaluated the prognostic impact of several clinicopathological variables in clinical T classification using a Cox proportional hazard model. Results On multivariable analysis, the presence of a GGO component (hazard ratio [HR], 0.314; 95% confidence interval [CI], 0.181-0.529: P P = .006) were identified as independently significant prognostic factors of overall survival. However, after accounting for the presence of a GGO component, neither maximum tumor size nor solid component size added to the prediction of long-term survival. Moreover, tumor size significantly affected survival outcome only in the solid group (HR, 1.020; 95% CI, 1.006-1.034; P = .004). Survival was excellent at ≥90% despite the revised T categories, provided that the tumor had a Ground Glass appearance. Meanwhile, tumor size significantly affected survival only in the solid group ( P Conclusions The presence of a GGO component is a significant prognostic factor in early-stage NSCLC. External validation is required to assess whether it should be adopted as a novel factor in clinical T staging.
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importance of Ground Glass Opacity component in clinical stage ia radiologic invasive lung cancer
The Annals of Thoracic Surgery, 2017Co-Authors: Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Kenji SuzukiAbstract:BackGround We evaluated the clinical significance of the presence of a Ground Glass Opacity (GGO) component in clinical stage IA radiologic invasive non-small cell lung cancer (NSCLC). Methods We reviewed 497 surgically resected clinical stage IA radiologic invasive NSCLCs, which were then classified into two groups based on consolidation tumor ratio (CTR), that is part-solid (0.5 ≤ CTR Results Among the radiologic invasive NSCLCs, multivariate analyses revealed that the presence of the carcinoembryonic antigen and a radiologic pure-solid appearance were independent significant prognostic variables ( p = 0.019 and 0.034). The 5-year overall survival (OS) revealed significant differences between pure-solid and part-solid tumors (82.7% versus 95.3%, p p = 0.0274). However, oncologic characteristics between GGO-predominant and solid-predominant types are clinicopathologically similar. The 5-year OS was equivalent in the GGO-predominant and solid-predominant arms (5-year OS: 95.3% versus 96.8%, p = 0.703). Furthermore, it was identical despite the maximum tumor size (≤20 mm: 96.6%, 21 to 30 mm: 94.9%, p = 0.4810) or the solid component size (≤20 mm: 96.0%, 21 to 30 mm: 93.8%, p = 0.6119). Conclusions Presence of a GGO component might have a notable impact on a favorable prognosis even in clinical stage IA radiologic invasive NSCLCs. Therefore, a clear distinction between part-solid and pure-solid findings on thin-section computed tomography is extremely important when evaluating the oncologic outcomes of radiologically solid NSCLCs.
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a nonrandomized confirmatory phase iii study of sublobar surgical resection for peripheral Ground Glass Opacity dominant lung cancer defined with thoracic thin section computed tomography jcog0804 wjog4507l
Journal of Clinical Oncology, 2017Co-Authors: Kenji Suzuki, Tetsuya Mitsudomi, Shunichi Watanabe, Masashi Wakabayashi, Yasumitsu Moriya, Ichiro Yoshino, Masahiro Tsuboi, Hisao AsamuraAbstract:8561BackGround: The optimal mode of surgery for peripheral Ground Glass Opacity (GGO) dominant lung cancer (LC) defined with thoracic thin-section computed tomography (TSCT) remains unknown. Method...
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a non randomized confirmatory trial of segmentectomy for clinical t1n0 lung cancer with dominant Ground Glass Opacity based on thin section computed tomography jcog1211
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2017Co-Authors: Keiju Aokage, Kenji Suzuki, Hisashi Saji, Tomonori Mizutani, Hiroshi Katayama, Taro Shibata, Syunichi Watanabe, Hisao AsamuraAbstract:Introduction Lobectomy has been the standard surgery for even stage I lung cancer since the validity of limited resection for stage I lung cancer was denied by the randomized study reported in 1995. The aim of this non-randomized confirmatory going on since September 2013 is to confirm the efficacy of a segmentectomy for clinical T1N0 lung cancer with dominant Ground Glass Opacity based on thin-slice computed tomography.
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neither maximum tumor size nor solid component size is prognostic in part solid lung cancer impact of tumor size should be applied exclusively to solid lung cancer
The Annals of Thoracic Surgery, 2016Co-Authors: Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Kenji SuzukiAbstract:BackGround We aimed to investigate the prognostic impact of tumor size based on the consolidation status by thin-section computed tomography. Methods We evaluated 1,181 surgically resected clinical N0 M0 non-small cell lung carcinomas. Consolidation tumor ratio (CTR) was evaluated for all, and tumors were classified into three groups, namely pure Ground-Glass Opacity (CTR = 0; n = 168), part-solid (0 Results Tumor size significantly differentiated the 5-year overall survival (≤20 mm; n = 638: 93.4%; 21–30 mm; n = 284: 84.2%; 31–50 mm; n = 193: 69.3%; ≥51 mm; n = 66: 43.5%; p p p = 0.1028; 0 p = 0.1247). Furthermore, maximum tumor size ( p = 0.6370), solid component size ( p = 0.2340), and CTR ( p = 0.1395) were not associated with poor overall survival in radiologic part-solid lung cancer. Conclusions The impact of maximum tumor size should be applied only to radiologic solid lung cancer without the Ground-Glass Opacity component on thin-section computed tomography. On the other hand, we recommend that pure Ground-Glass Opacity and part-solid lung cancers be described, respectively, as clinical-Tis and clinical-T1a, which are independent of maximum tumor size and solid component size on thin-section computed tomography.
Kyung Soo Lee - One of the best experts on this subject based on the ideXlab platform.
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quantitative ct scanning analysis of pure Ground Glass Opacity nodules predicts further ct scanning change
Chest, 2016Co-Authors: Ho Yu Lee, Jaehu Kim, Jung O Kwo, Jhingook Kim, Hong Kwa Kim, Kyung Soo LeeAbstract:BackGround We sought to determine whether quantitative analysis of lung adenocarcinoma manifesting as a Ground-Glass Opacity (GGO) nodule (GGN) on initial CT scans can predict further CT scanning change or rate of growth. Methods This retrospective study included patients with lung adenocarcinoma manifesting as pure GGN on initial CT scans who were followed up with interval CT scanning until resection. All pure GGNs were classified based on CT scanning interval change in three subgroups as follows: group A (development of solid component), group B (growth of GGO component), and group C (no change in size). Nodule size, volume, density, mass, and CT scanning attenuation values were assessed from initial CT data sets. Results Fifty-four pure GGNs were enrolled and classified into group A (n = 9), group B (n = 25), and group C (n = 20). Nodule size, volume, mass, and density of the GGNs in each subgroup were not significantly different. The 97.5th percentile CT scanning attenuation value and slope of CT scanning attenuation values from the 2.5th to the 97.5th percentile were significantly different among the three subgroups ( P = .02, P Conclusions The 97.5th percentile CT scanning attenuation value and slope of CT scanning attenuation values from the 2.5th to the 97.5th percentile could be helpful in predicting future CT scanning change and growth rate of pure GGNs. Pure GGNs showing higher 97.5th percentile CT scanning attenuation values and steeper slopes of CT scanning attenuation values may require more frequent follow-up than the usual interval of 6 months.
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quantitative ct analysis of pulmonary Ground Glass Opacity nodules for the distinction of invasive adenocarcinoma from pre invasive or minimally invasive adenocarcinoma
PLOS ONE, 2014Co-Authors: Ho Yu Lee, Kyung Soo Lee, Jaehu Kim, Ji Yu Jeong, Jung O Kwo, Young Mog ShimAbstract:Objectives We aimed to analyze the CT findings of Ground-Glass Opacity nodules diagnosed pathologically as adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma in order to investigate whether quantitative CT parameters enable distinction of invasive adenocarcinoma from pre-invasive or minimally invasive adenocarcinoma. Methods We reviewed CT images and pathologic specimens from 191 resected Ground-Glass Opacity nodules with little or no solid component at CT. Nodule size, volume, density, mass, skewness/kurtosis, and CT attenuation values at the 2.5th–97.5th percentiles on histogram, and texture parameters (uniformity and entropy) were assessed from CT datasets. Results Of 191 tumors, 38 were AISs (20%), 61 were MIAs (32%), and 92 (48%) were invasive adenocarcinomas. Multivariate logistic regression analysis helped identify the 75th percentile CT attenuation value (P = 0.04) and entropy (P<0.01) as independent predictors for invasive adenocarcinoma, with an area under the receiver operating characteristic curve of 0.780. Conclusion Quantitative analysis of preoperative CT imaging metrics can help distinguish invasive adenocarcinoma from pre-invasive or minimally invasive adenocarcinoma.
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pure Ground Glass Opacity neoplastic lung nodules histopathology imaging and management
American Journal of Roentgenology, 2014Co-Authors: Ho Yu Lee, Kyung Soo Lee, Yoonla Choi, Young Mog Shim, Jung Wo MooAbstract:OBJECTIVE. The purpose of this article is to discuss histologic diagnosis of pure pulmonary Ground-Glass Opacity nodules (GGNs), high-resolution CT (HRCT) findings and pathologic correlation, and management. CONCLUSION. When pure GGNs are greater than 15 mm in diameter with nodularity or have high pixel attenuation (> −472 HU), the nodules are more likely to be invasive adenocarcinomas. Sublobar resection with a secured safety margin and without nodal dissection is performed for HRCT-suggested pure-GGN invasive adenocarcinomas and has a 100% 5-year survival rate.
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persistent pure Ground Glass Opacity lung nodules 10 mm in diameter at ct scan histopathologic comparisons and prognostic implications
Chest, 2013Co-Authors: Hyunju Lim, Kyung Soo Lee, Young Mog Shim, Jaehu Kim, Sookyoung Woo, Miyeo Yie, Ho Yu LeeAbstract:BackGround Little is known about the histopathology and prognosis of persistent pure Ground-Glass Opacity nodules (GGNs) of ≥ 10 mm in diameter. We aimed to compare the morphologic features of persistent pure GGNs of ≥ 10 mm in diameter at thin-section CT (TSCT) scan with histopathology and patient prognosis. Methods A total of 46 resected GGNs that were evaluated with TSCT scan and followed up for ≥ 3 years were included in this study. Correlations between histopathology (adenocarcinoma in situ [AIS], minimally invasive adenocarcinoma [MIA], and invasive adenocarcinoma) and CT scan characteristics were examined. CT scan and clinicodemographic data were investigated by univariate and multivariate analyses to identify features that helped distinguish invasive adenocarcinoma from AIS or MIA. Disease recurrence was also evaluated. Results The nodules included 19 AISs (41%), nine MIAs (20%), and 18 invasive adenocarcinomas (39%). On univariate analysis, the presence of air bronchogram ( P = .012), size of nodule ( P = .032, cutoff=16.4 mm in diameter), and mass of nodule ( P = .040, cutoff=0.472 g) were significant factors that differentiated invasive adenocarcinoma from AIS or MIA. On multivariate analysis, size ( P = .010) and mass of nodule ( P = .016) were significant determinants for invasive adenocarcinoma. There were no cases of recurrence during a follow-up period of ≥ 3 years after surgical resection. Conclusions In persistent pure GGNs of ≥ 10 mm in diameter, the size and mass of the nodule are determinants of invasive adenocarcinoma, for which surgical resection leads to excellent prognosis.
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natural history of pure Ground Glass Opacity lung nodules detected by low dose ct scan
Chest, 2013Co-Authors: Oksoo Chang, Man Pyo Chung, Kyung Soo Lee, Ho Yu Lee, Jung O Kwo, Jung Hye Hwang, Yoonho Choi, Hojoong Kim, Young Mog ShimAbstract:BackGround Although focal Ground-Glass Opacity (GGO) lung nodules are generally reported to grow slowly, their natural course is unclear. The purpose of this study was to elucidate the natural course of screening-detected pure GGO lung nodules in patients with no history of malignancy. Methods We retrospectively reviewed the database of subjects who had undergone screenings involving low-dose CT scans. We included patients with pure GGO lung nodules who were followed for > 2 years after the initial screening. Results Between June 1997 and September 2006, 122 pure GGO nodules were found in 89 patients. The median nodule size was 5.5 mm (range, 3-20 mm) in the largest diameter on initial low-dose CT scan. The median follow-up period per patient was 59 months. On a per-person basis, the frequency of growth was 13.5% (12 of 89 patients). On a per-nodule basis, the frequency of growth was 9.8% (12 of 122 nodules). Nodule growth was significantly associated with initial size and new development of an internal solid portion. The median volume doubling time was 769 days for growing pure GGO nodules. A total of 11 growing nodules were surgically validated, and all lesions were confirmed as primary lung cancer. Conclusions About 90% of the screening-detected pure GGO lung nodules did not grow during long-term follow-up in subjects with no history of malignancy and most growing nodules had an indolent clinical course. A strategy of long-term follow-up and selective surgery for growing nodules should be considered for pure GGO lung nodules.
Young Mog Shim - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of wedge resection for pulmonary Ground Glass Opacity nodules
The Annals of Thoracic Surgery, 2015Co-Authors: Jong Ho Cho, Yong Soo Choi, Jhingook Kim, Hong Kwan Kim, Young Mog ShimAbstract:BackGround We aimed to characterize Ground-Glass Opacity (GGO) nodules and evaluate the prognosis of clinical stage IA lung adenocarcinoma with GGO nodules after wedge resection. Methods Patients who underwent wedge resection for early stage lung cancer and proven adenocarcinoma on postoperative pathologic report were enrolled in the study between 2004 and 2010. Radiologic findings of the main tumor were evaluated for Ground-Glass opacities with chest computed tomography (CT). We divided patients into two groups based on the consolidation-to-tumor ratio (C/T ratio ≤0.25, pure GGO group; C/T ratio >0.25, mixed GGO group). Overall survival and recurrence-free survival were analyzed for all patients. Results A total of 97 patients were included in our study. Among these, 71 patients were categorized into the pure GGO group and 26 patients into the mixed GGO group. The 5-year overall survival rate was 98.6% in the pure GGO group and 95.5% in the mixed GGO group ( p = 0.663). Five patients (5.1%) experienced recurrences; only 1 patient (1/71, 1.4%) in the pure GGO group and 4 patients (4/26, 15.3%) in the mixed GGO group had recurrence. Conclusions GGO-dominant clinical stage IA lung adenocarcinoma (pure GGO group) showed an excellent prognosis. Wedge resection should be carefully considered for patients with mixed GGO nodules (C/T ratio >0.25) because of the high recurrence rate. Radiologic noninvasiveness (C/T ratio ≤0.25) might be a good indicator for candidates for sublobar resection in cases of early stage lung adenocarcinoma.
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quantitative ct analysis of pulmonary Ground Glass Opacity nodules for the distinction of invasive adenocarcinoma from pre invasive or minimally invasive adenocarcinoma
PLOS ONE, 2014Co-Authors: Ho Yu Lee, Kyung Soo Lee, Jaehu Kim, Ji Yu Jeong, Jung O Kwo, Young Mog ShimAbstract:Objectives We aimed to analyze the CT findings of Ground-Glass Opacity nodules diagnosed pathologically as adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma in order to investigate whether quantitative CT parameters enable distinction of invasive adenocarcinoma from pre-invasive or minimally invasive adenocarcinoma. Methods We reviewed CT images and pathologic specimens from 191 resected Ground-Glass Opacity nodules with little or no solid component at CT. Nodule size, volume, density, mass, skewness/kurtosis, and CT attenuation values at the 2.5th–97.5th percentiles on histogram, and texture parameters (uniformity and entropy) were assessed from CT datasets. Results Of 191 tumors, 38 were AISs (20%), 61 were MIAs (32%), and 92 (48%) were invasive adenocarcinomas. Multivariate logistic regression analysis helped identify the 75th percentile CT attenuation value (P = 0.04) and entropy (P<0.01) as independent predictors for invasive adenocarcinoma, with an area under the receiver operating characteristic curve of 0.780. Conclusion Quantitative analysis of preoperative CT imaging metrics can help distinguish invasive adenocarcinoma from pre-invasive or minimally invasive adenocarcinoma.
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pure Ground Glass Opacity neoplastic lung nodules histopathology imaging and management
American Journal of Roentgenology, 2014Co-Authors: Ho Yu Lee, Kyung Soo Lee, Yoonla Choi, Young Mog Shim, Jung Wo MooAbstract:OBJECTIVE. The purpose of this article is to discuss histologic diagnosis of pure pulmonary Ground-Glass Opacity nodules (GGNs), high-resolution CT (HRCT) findings and pathologic correlation, and management. CONCLUSION. When pure GGNs are greater than 15 mm in diameter with nodularity or have high pixel attenuation (> −472 HU), the nodules are more likely to be invasive adenocarcinomas. Sublobar resection with a secured safety margin and without nodal dissection is performed for HRCT-suggested pure-GGN invasive adenocarcinomas and has a 100% 5-year survival rate.
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persistent pure Ground Glass Opacity lung nodules 10 mm in diameter at ct scan histopathologic comparisons and prognostic implications
Chest, 2013Co-Authors: Hyunju Lim, Kyung Soo Lee, Young Mog Shim, Jaehu Kim, Sookyoung Woo, Miyeo Yie, Ho Yu LeeAbstract:BackGround Little is known about the histopathology and prognosis of persistent pure Ground-Glass Opacity nodules (GGNs) of ≥ 10 mm in diameter. We aimed to compare the morphologic features of persistent pure GGNs of ≥ 10 mm in diameter at thin-section CT (TSCT) scan with histopathology and patient prognosis. Methods A total of 46 resected GGNs that were evaluated with TSCT scan and followed up for ≥ 3 years were included in this study. Correlations between histopathology (adenocarcinoma in situ [AIS], minimally invasive adenocarcinoma [MIA], and invasive adenocarcinoma) and CT scan characteristics were examined. CT scan and clinicodemographic data were investigated by univariate and multivariate analyses to identify features that helped distinguish invasive adenocarcinoma from AIS or MIA. Disease recurrence was also evaluated. Results The nodules included 19 AISs (41%), nine MIAs (20%), and 18 invasive adenocarcinomas (39%). On univariate analysis, the presence of air bronchogram ( P = .012), size of nodule ( P = .032, cutoff=16.4 mm in diameter), and mass of nodule ( P = .040, cutoff=0.472 g) were significant factors that differentiated invasive adenocarcinoma from AIS or MIA. On multivariate analysis, size ( P = .010) and mass of nodule ( P = .016) were significant determinants for invasive adenocarcinoma. There were no cases of recurrence during a follow-up period of ≥ 3 years after surgical resection. Conclusions In persistent pure GGNs of ≥ 10 mm in diameter, the size and mass of the nodule are determinants of invasive adenocarcinoma, for which surgical resection leads to excellent prognosis.
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natural history of pure Ground Glass Opacity lung nodules detected by low dose ct scan
Chest, 2013Co-Authors: Oksoo Chang, Man Pyo Chung, Kyung Soo Lee, Ho Yu Lee, Jung O Kwo, Jung Hye Hwang, Yoonho Choi, Hojoong Kim, Young Mog ShimAbstract:BackGround Although focal Ground-Glass Opacity (GGO) lung nodules are generally reported to grow slowly, their natural course is unclear. The purpose of this study was to elucidate the natural course of screening-detected pure GGO lung nodules in patients with no history of malignancy. Methods We retrospectively reviewed the database of subjects who had undergone screenings involving low-dose CT scans. We included patients with pure GGO lung nodules who were followed for > 2 years after the initial screening. Results Between June 1997 and September 2006, 122 pure GGO nodules were found in 89 patients. The median nodule size was 5.5 mm (range, 3-20 mm) in the largest diameter on initial low-dose CT scan. The median follow-up period per patient was 59 months. On a per-person basis, the frequency of growth was 13.5% (12 of 89 patients). On a per-nodule basis, the frequency of growth was 9.8% (12 of 122 nodules). Nodule growth was significantly associated with initial size and new development of an internal solid portion. The median volume doubling time was 769 days for growing pure GGO nodules. A total of 11 growing nodules were surgically validated, and all lesions were confirmed as primary lung cancer. Conclusions About 90% of the screening-detected pure GGO lung nodules did not grow during long-term follow-up in subjects with no history of malignancy and most growing nodules had an indolent clinical course. A strategy of long-term follow-up and selective surgery for growing nodules should be considered for pure GGO lung nodules.
Morihito Okada - One of the best experts on this subject based on the ideXlab platform.
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appropriate sublobar resection choice for Ground Glass Opacity dominant clinical stage ia lung adenocarcinoma wedge resection or segmentectomy
Chest, 2014Co-Authors: Yasuhiro Tsutani, Haruhiko Nakayama, Sakae Okumura, Shuji Adachi, Masahiro Yoshimura, Yoshihiro Miyata, Morihito OkadaAbstract:BackGround The purpose of this multicenter study was to characterize Ground Glass Opacity (GGO)-dominant clinical stage IA lung adenocarcinomas and evaluate prognosis of these tumors after sublobar resection, such as segmentectomy and wedge resection. Methods We evaluated 610 consecutive patients with clinical stage IA lung adenocarcinoma who underwent complete resection after preoperative high-resolution CT scanning and 18 F-fluorodeoxyglucose PET/CT scanning and revealed 239 (39.2%) that had a > 50% GGO component. Results GGO-dominant tumors rarely exhibited pathologic invasiveness, including lymphatic, vascular, or pleural invasion and lymph node metastasis. There was no significant difference in 3-year recurrence-free survival (RFS) among patients who underwent lobectomy (96.4%), segmentectomy (96.1%), and wedge resection (98.7%) of GGO-dominant tumors ( P = .44). Furthermore, for GGO-dominant T1b tumors, 3-year RFS was similar in patients who underwent lobectomy (93.7%), segmentectomy (92.9%), and wedge resection (100%, P = .66). Two of 84 patients (2.4%) with GGO-dominant T1b tumors had lymph node metastasis. Multivariate Cox analysis showed that tumor size, maximum standardized uptake value on 18 F-fluorodeoxyglucose PET/CT scan, and surgical procedure did not affect RFS in GGO-dominant tumors. Conclusions GGO-dominant clinical stage IA lung adenocarcinomas are a uniform group of tumors that exhibit low-grade malignancy and have an extremely favorable prognosis. Patients with GGO-dominant clinical stage IA adenocarcinomas can be successfully treated with wedge resection of a T1a tumor and segmentectomy of a T1b tumor.
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solid tumors versus mixed tumors with a Ground Glass Opacity component in patients with clinical stage ia lung adenocarcinoma prognostic comparison using high resolution computed tomography findings
The Journal of Thoracic and Cardiovascular Surgery, 2013Co-Authors: Yasuhiro Tsutani, Haruhiko Nakayama, Sakae Okumura, Shuji Adachi, Masahiro Yoshimura, Yoshihiro Miyata, Takeharu Yamanaka, Morihito OkadaAbstract:Objective This study aimed to compare malignant behavior and prognosis between solid tumors and mixed tumors with a Ground-Glass Opacity component on high-resolution computed tomography. Methods We examined 436 of 502 consecutive patients with clinical stage IA adenocarcinoma who had undergone preoperative high-resolution computed tomography and F-18-fluorodeoxyglucose positron emission tomography/computed tomography; 66 patients with tumors with pure Ground-Glass Opacity components were excluded. Tumor type (solid, n = 137; mixed, n = 299) and surgical results were analyzed for all patients and their matched pairs. Results In all patients, solid tumors showed a significantly greater association ( P P = .0006). Analysis of 97 pairs matched for solid component size confirmed that solid tumors were significantly associated with lymphatic, vascular, and pleural invasion ( P = .008, P = .029, P = .003, respectively) and poor prognosis. When maximum standardized uptake value and solid component size were matched (n = 79), the differences in pathologic prognostic parameters and disease-free survivals between patients with solid and mixed tumors disappeared. Conclusions Solid tumors exhibit more malignant behavior and have a poorer prognosis compared with mixed tumors, even when the solid component size is the same in both tumor types. However, differences in malignant behavior can be identified using maximum standardized uptake values determined by F-18-fluorodeoxyglucose positron emission tomography/computed tomography.
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multicenter analysis of high resolution computed tomography and positron emission tomography computed tomography findings to choose therapeutic strategies for clinical stage ia lung adenocarcinoma
The Journal of Thoracic and Cardiovascular Surgery, 2011Co-Authors: Morihito Okada, Hiromitsu Daisaki, Haruhiko Nakayama, Sakae Okumura, Shuji Adachi, Masahiro Yoshimura, Yoshihiro MiyataAbstract:Objective The detection rates of small lung cancers, especially adenocarcinoma, have recently increased. An understanding of malignant aggressiveness is critical for the selection of suitable therapeutic strategies, such as sublobar resection. The objective of this study was to examine the malignant biological behavior of clinical stage IA adenocarcinoma and to select therapeutic strategies using high-resolution computed tomography, fluorodeoxyglucose-positron emission tomography/computed tomography, and a pathologic analysis in the setting of a multicenter study. Methods We performed high-resolution computed tomography and fluorodeoxyglucose-positron emission tomography/computed tomography in 502 patients with clinical T1N0M0 adenocarcinoma before they underwent surgery with curative intent. We evaluated the relationships between clinicopathologic characteristics and maximum standardized uptake values on fluorodeoxyglucose-positron emission tomography/computed tomography, Ground-Glass Opacity ratio, and tumor disappearance rate on high-resolution computed tomography and component of bronchioloalveolar carcinoma on surgical specimens, as well as between these and surgical findings. We used a phantom study to correct the serious limitation of any multi-institution study using positron emission tomography/computed tomography, namely, a discrepancy in maximum standardized uptake values among institutions. Results Analyses of receiver operating characteristic curves identified an optimal cutoff value to predict high-grade malignancy of 2.5 for revised maximum standardized uptake values, 20% for Ground-Glass Opacity ratio, 30% for tumor disappearance rate, and 30% for bronchioloalveolar carcinoma ratio. Maximum standardized uptake values and bronchioloalveolar carcinoma ratio, tumor disappearance rate, and Ground-Glass Opacity ratio mirrored the pathologic aggressiveness of tumor malignancy, nodal metastasis, recurrence, and prognosis, including disease-free and overall survival. Conclusions Maximum standardized uptake value is a significant preoperative predictor for surgical outcomes. High-resolution computed tomography and fluorodeoxyglucose-positron emission tomography/computed tomography findings are important to determine the appropriateness of sublobar resection for treating clinical stage IA adenocarcinoma of the lung.
Ho Yu Lee - One of the best experts on this subject based on the ideXlab platform.
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quantitative ct scanning analysis of pure Ground Glass Opacity nodules predicts further ct scanning change
Chest, 2016Co-Authors: Ho Yu Lee, Jaehu Kim, Jung O Kwo, Jhingook Kim, Hong Kwa Kim, Kyung Soo LeeAbstract:BackGround We sought to determine whether quantitative analysis of lung adenocarcinoma manifesting as a Ground-Glass Opacity (GGO) nodule (GGN) on initial CT scans can predict further CT scanning change or rate of growth. Methods This retrospective study included patients with lung adenocarcinoma manifesting as pure GGN on initial CT scans who were followed up with interval CT scanning until resection. All pure GGNs were classified based on CT scanning interval change in three subgroups as follows: group A (development of solid component), group B (growth of GGO component), and group C (no change in size). Nodule size, volume, density, mass, and CT scanning attenuation values were assessed from initial CT data sets. Results Fifty-four pure GGNs were enrolled and classified into group A (n = 9), group B (n = 25), and group C (n = 20). Nodule size, volume, mass, and density of the GGNs in each subgroup were not significantly different. The 97.5th percentile CT scanning attenuation value and slope of CT scanning attenuation values from the 2.5th to the 97.5th percentile were significantly different among the three subgroups ( P = .02, P Conclusions The 97.5th percentile CT scanning attenuation value and slope of CT scanning attenuation values from the 2.5th to the 97.5th percentile could be helpful in predicting future CT scanning change and growth rate of pure GGNs. Pure GGNs showing higher 97.5th percentile CT scanning attenuation values and steeper slopes of CT scanning attenuation values may require more frequent follow-up than the usual interval of 6 months.
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quantitative ct analysis of pulmonary Ground Glass Opacity nodules for the distinction of invasive adenocarcinoma from pre invasive or minimally invasive adenocarcinoma
PLOS ONE, 2014Co-Authors: Ho Yu Lee, Kyung Soo Lee, Jaehu Kim, Ji Yu Jeong, Jung O Kwo, Young Mog ShimAbstract:Objectives We aimed to analyze the CT findings of Ground-Glass Opacity nodules diagnosed pathologically as adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma in order to investigate whether quantitative CT parameters enable distinction of invasive adenocarcinoma from pre-invasive or minimally invasive adenocarcinoma. Methods We reviewed CT images and pathologic specimens from 191 resected Ground-Glass Opacity nodules with little or no solid component at CT. Nodule size, volume, density, mass, skewness/kurtosis, and CT attenuation values at the 2.5th–97.5th percentiles on histogram, and texture parameters (uniformity and entropy) were assessed from CT datasets. Results Of 191 tumors, 38 were AISs (20%), 61 were MIAs (32%), and 92 (48%) were invasive adenocarcinomas. Multivariate logistic regression analysis helped identify the 75th percentile CT attenuation value (P = 0.04) and entropy (P<0.01) as independent predictors for invasive adenocarcinoma, with an area under the receiver operating characteristic curve of 0.780. Conclusion Quantitative analysis of preoperative CT imaging metrics can help distinguish invasive adenocarcinoma from pre-invasive or minimally invasive adenocarcinoma.
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pure Ground Glass Opacity neoplastic lung nodules histopathology imaging and management
American Journal of Roentgenology, 2014Co-Authors: Ho Yu Lee, Kyung Soo Lee, Yoonla Choi, Young Mog Shim, Jung Wo MooAbstract:OBJECTIVE. The purpose of this article is to discuss histologic diagnosis of pure pulmonary Ground-Glass Opacity nodules (GGNs), high-resolution CT (HRCT) findings and pathologic correlation, and management. CONCLUSION. When pure GGNs are greater than 15 mm in diameter with nodularity or have high pixel attenuation (> −472 HU), the nodules are more likely to be invasive adenocarcinomas. Sublobar resection with a secured safety margin and without nodal dissection is performed for HRCT-suggested pure-GGN invasive adenocarcinomas and has a 100% 5-year survival rate.
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persistent pure Ground Glass Opacity lung nodules 10 mm in diameter at ct scan histopathologic comparisons and prognostic implications
Chest, 2013Co-Authors: Hyunju Lim, Kyung Soo Lee, Young Mog Shim, Jaehu Kim, Sookyoung Woo, Miyeo Yie, Ho Yu LeeAbstract:BackGround Little is known about the histopathology and prognosis of persistent pure Ground-Glass Opacity nodules (GGNs) of ≥ 10 mm in diameter. We aimed to compare the morphologic features of persistent pure GGNs of ≥ 10 mm in diameter at thin-section CT (TSCT) scan with histopathology and patient prognosis. Methods A total of 46 resected GGNs that were evaluated with TSCT scan and followed up for ≥ 3 years were included in this study. Correlations between histopathology (adenocarcinoma in situ [AIS], minimally invasive adenocarcinoma [MIA], and invasive adenocarcinoma) and CT scan characteristics were examined. CT scan and clinicodemographic data were investigated by univariate and multivariate analyses to identify features that helped distinguish invasive adenocarcinoma from AIS or MIA. Disease recurrence was also evaluated. Results The nodules included 19 AISs (41%), nine MIAs (20%), and 18 invasive adenocarcinomas (39%). On univariate analysis, the presence of air bronchogram ( P = .012), size of nodule ( P = .032, cutoff=16.4 mm in diameter), and mass of nodule ( P = .040, cutoff=0.472 g) were significant factors that differentiated invasive adenocarcinoma from AIS or MIA. On multivariate analysis, size ( P = .010) and mass of nodule ( P = .016) were significant determinants for invasive adenocarcinoma. There were no cases of recurrence during a follow-up period of ≥ 3 years after surgical resection. Conclusions In persistent pure GGNs of ≥ 10 mm in diameter, the size and mass of the nodule are determinants of invasive adenocarcinoma, for which surgical resection leads to excellent prognosis.
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natural history of pure Ground Glass Opacity lung nodules detected by low dose ct scan
Chest, 2013Co-Authors: Oksoo Chang, Man Pyo Chung, Kyung Soo Lee, Ho Yu Lee, Jung O Kwo, Jung Hye Hwang, Yoonho Choi, Hojoong Kim, Young Mog ShimAbstract:BackGround Although focal Ground-Glass Opacity (GGO) lung nodules are generally reported to grow slowly, their natural course is unclear. The purpose of this study was to elucidate the natural course of screening-detected pure GGO lung nodules in patients with no history of malignancy. Methods We retrospectively reviewed the database of subjects who had undergone screenings involving low-dose CT scans. We included patients with pure GGO lung nodules who were followed for > 2 years after the initial screening. Results Between June 1997 and September 2006, 122 pure GGO nodules were found in 89 patients. The median nodule size was 5.5 mm (range, 3-20 mm) in the largest diameter on initial low-dose CT scan. The median follow-up period per patient was 59 months. On a per-person basis, the frequency of growth was 13.5% (12 of 89 patients). On a per-nodule basis, the frequency of growth was 9.8% (12 of 122 nodules). Nodule growth was significantly associated with initial size and new development of an internal solid portion. The median volume doubling time was 769 days for growing pure GGO nodules. A total of 11 growing nodules were surgically validated, and all lesions were confirmed as primary lung cancer. Conclusions About 90% of the screening-detected pure GGO lung nodules did not grow during long-term follow-up in subjects with no history of malignancy and most growing nodules had an indolent clinical course. A strategy of long-term follow-up and selective surgery for growing nodules should be considered for pure GGO lung nodules.
