HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Noriaki Tsubota Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Okada, M. Articles by Tsubota, N. Search for Related Content PubMed PubMed Citation Articles by Okada, M. Articles by Tsubota, N. Related Collections Lung - cancer

J Thorac Cardiovasc Surg 2004;127:857-861
© 2004 The American Association for Thoracic Surgery

General thoracic surgery

Correlation between computed tomographic findings, bronchioloalveolar carcinoma component, and biologic behavior of small-sized lung adenocarcinomas

^a Department of Thoracic Surgery, Hyogo Medical Center for Adults, Akashi, Hyogo, Japan
^b Department of Pathology, Hyogo Medical Center for Adults, Akashi, Hyogo, Japan
^c Department of Surgical Pathology, Kobe University Medical School, Kobe, Hyogo, Japan

Received for publication March 31, 2003; revisions received May 27, 2003; revisions received July 29, 2003; accepted for publication August 11, 2003.

^* Address for reprints: Morihito Okada, MD, PhD, Department of Thoracic Surgery, Hyogo Medical Center for Adults, Kitaohji-cho13-70, Akashi City 673-8558, Hyogo , Japan
morihito1217jp{at}aol.com

OBJECTIVE: Differentiation of bronchioloalveolar carcinoma from other subtypes of lung adenocarcinomas is important in the preoperative assessment of patients. We examined the biologic aggressiveness of small-sized adenocarcinomas according to the pathologically defined bronchioloalveolar carcinoma degree and its correlation with computed tomography findings. In addition, we attempted to predict which patients were suitable for a lesser resection.

METHODS: Of 424 consecutive patients who underwent operation for primary lung cancer in the last 3 years, 114 with a histopathologically proven adenocarcinoma 3 cm or less in diameter underwent complete removal of the primary tumor. We examined the characteristics of patients classified into 3 groups based on the proportion of the bronchioloalveolar carcinoma component: 0% to 20% (n = 40), 21% to 50% (n = 38), and 51% to 100% (n = 36). We also investigated the correlation of the bronchioloalveolar carcinoma component with computed tomography findings such as ground-glass opacity (defined as a hazy increase on the lung window) and tumor shadow disappearance rate (defined as the ratio of the tumor area of the mediastinal window to that of the lung window).

RESULTS: Male gender (P = .0001), advanced pathologic stage (P = .001), larger size of the tumor (P = .004), nodal involvement (P = .04), pleural invasion (P = .0003), lymphatic invasion (P = .002), and vascular invasion (P = .0002) were observed more often among patients with a smaller proportion of bronchioloalveolar carcinoma. A positive and significant correlation was found between the rate of bronchioloalveolar carcinoma component and ground-glass opacity (R² = 0.488, P < .0001) and tumor shadow disappearance rate (R² = 0.727, P < .0001). As an independent predictor of nodal status, tumor shadow disappearance rate (P = .015) and bronchioloalveolar carcinoma component (P = .015), as well as tumor size, were significantly valuable, although ground-glass opacity proportion (P = .086) was marginally informative.

CONCLUSIONS: Small-sized adenocarcinomas with a greater ratio of bronchioloalveolar carcinoma component showed less aggressive behavior. Both tumor shadow disappearance rate and ground-glass opacity ratios, which are obtained preoperatively, were well associated with bronchioloalveolar carcinoma ratios, which are determined postoperatively. Furthermore, tumor shadow disappearance rate had a stronger impact as a predictor of bronchioloalveolar carcinoma component. Preoperative assessment of tumor shadow disappearance rate may be useful to identify patients requiring a less extensive pulmonary resection.

This article has been cited by other articles:

				H. Nakayama and H. Ito Reply Ann. Thorac. Surg., November 1, 2008; 86(5): 1724 - 1725. [Full Text] [PDF]

				B. Goudarzi, H. A. Jacene, and R. L. Wahl Diagnosis and Differentiation of Bronchioloalveolar Carcinoma from Adenocarcinoma with Bronchioloalveolar Components with Metabolic and Anatomic Characteristics Using PET/CT J. Nucl. Med., October 1, 2008; 49(10): 1585 - 1592. [Abstract] [Full Text] [PDF]

				M. Inoue, T. Takakuwa, M. Minami, H. Shiono, T. Utsumi, Y. Kadota, T. Nasu, K. Aozasa, and M. Okumura Clinicopathologic factors influencing postoperative prognosis in patients with small-sized adenocarcinoma of the lung. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 830 - 836. [Abstract] [Full Text] [PDF]

				H. Nakayama, K. Yamada, H. Saito, F. Oshita, H. Ito, Y. Kameda, and K. Noda Sublobar Resection for Patients With Peripheral Small Adenocarcinomas of the Lung: Surgical Outcome is Associated With Features on Computed Tomographic Imaging Ann. Thorac. Surg., November 1, 2007; 84(5): 1675 - 1679. [Abstract] [Full Text] [PDF]

				M. Okada, S. Tauchi, K. Iwanaga, T. Mimura, Y. Kitamura, H. Watanabe, S. Adachi, T. Sakuma, and C. Ohbayashi Associations among bronchioloalveolar carcinoma components, positron emission tomographic and computed tomographic findings, and malignant behavior in small lung adenocarcinomas J. Thorac. Cardiovasc. Surg., June 1, 2007; 133(6): 1448 - 1454. [Abstract] [Full Text] [PDF]

				M. Okada, T. Koike, M. Higashiyama, Y. Yamato, K. Kodama, and N. Tsubota Radical sublobar resection for small-sized non small cell lung cancer: A multicenter study J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 769 - 775. [Abstract] [Full Text] [PDF]

				M. Inoue, M. Minami, H. Shiono, N. Sawabata, K. Ideguchi, and M. Okumura Clinicopathologic study of resected, peripheral, small-sized, non-small cell lung cancer tumors of 2 cm or less in diameter: Pleural invasion and increase of serum carcinoembryonic antigen level as predictors of nodal involvement J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 988 - 993. [Abstract] [Full Text] [PDF]

				Y. Ohta, Y. Shimizu, T. Kobayashi, O. Matsui, H. Minato, I. Matsumoto, and G. Watanabe Pathologic and Biological Assessment of Lung Tumors Showing Ground-Glass Opacity Ann. Thorac. Surg., April 1, 2006; 81(4): 1194 - 1197. [Abstract] [Full Text] [PDF]

				H. Harada, M. Okada, T. Sakamoto, H. Matsuoka, and N. Tsubota Functional Advantage After Radical Segmentectomy Versus Lobectomy for Lung Cancer Ann. Thorac. Surg., December 1, 2005; 80(6): 2041 - 2045. [Abstract] [Full Text] [PDF]

				M. Okada, T. Sakamoto, T. Yuki, T. Mimura, K. Miyoshi, and N. Tsubota Hybrid Surgical Approach of Video-Assisted Minithoracotomy for Lung Cancer: Significance of Direct Visualization on Quality of Surgery Chest, October 1, 2005; 128(4): 2696 - 2701. [Abstract] [Full Text] [PDF]

				C. A. Meyer, R. T. Shipley, K. S. Lee, T. Johkoh, and R. Kakinuma Invited Commentary * Authors' Response RadioGraphics, November 1, 2004; 24(6): 1632 - 1636. [Full Text] [PDF]