Recommendation for Clinical T Staging in Patients with Non-Small Cell Lung Cancer: Volumetric Measurement: A Retrospective Study from Turkey.

Q4 Medicine
Muhammet Sayan, Aykut Kankoc, Muhammet Tarik Aslan, Irmak Akarsu, İsmail Cuneyt Kurul, Ali Celik
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引用次数: 0

Abstract

Background: Currently, clinical T staging in non-small cell lung cancer (NSCLC) is based on the largest radiological diameter observed on computed tomography (CT). Under this system, tumors with varying shapes-such as spherical, amorphous, or spiculated tumors- can be assigned the same T stage even with different volumes. We aimed to propose a 3-dimensional (3D) volumetric staging system for NSCLC as an alternative to diameter-based T staging and to conduct comparative survival analyses between these methods.

Methods: We retrospectively analyzed data from patients who underwent surgery for pT1-4N0M0 primary NSCLC between January 2018 and May 2022. Digital Imaging and Communications in Medicine data from patient CT scans were uploaded to 3D Slicer software for volumetric tumor measurement. Using the paired samples t-test or the Wilcoxon test, we compared the expected tumor volumes, calculated by tumor diameter, with the actual volumes measured by 3D Slicer. Receiver operating characteristic analysis was employed to determine the cut-off value for tumor volume. Kaplan-Meier analysis was utilized to assess overall survival, while the log-rank method was applied to compare survival differences between groups. The significance of changes in T stage was evaluated using the marginal homogeneity test.

Results: The study included 136 patients. Significant differences were observed between expected and actual tumor volumes (p=0.01), and associated changes in T stage were also significant (p=0.04). The survival analysis performed using tumor volume (p=0.009) yielded superior results compared to that based on diameter (p=0.04) in paients with early tumor stage.

Conclusion: T-factor staging based on tumor volume could represent an alternative staging method for NSCLC.

非小细胞肺癌患者临床 T 分期建议:体积测量:土耳其的一项回顾性研究
背景:目前,非小细胞肺癌(NSCLC)的临床 T 分期基于计算机断层扫描(CT)观察到的最大放射直径。在这一系统下,形状各异的肿瘤,如球形、无定形或棘状肿瘤,即使体积不同,也能被分配到相同的 T 分期。我们的目的是为 NSCLC 提出一种三维(3D)容积分期系统,作为基于直径的 T 分期的替代方法,并对这两种方法的生存率进行比较分析:我们回顾性分析了2018年1月至2022年5月期间接受pT1-4N0M0原发性NSCLC手术的患者数据。来自患者CT扫描的数字成像和医学通信数据被上传到3D Slicer软件中进行肿瘤体积测量。通过配对样本 t 检验或 Wilcoxon 检验,我们比较了根据肿瘤直径计算的预期肿瘤体积和 3D Slicer 测量的实际肿瘤体积。采用接收者操作特征分析来确定肿瘤体积的临界值。采用 Kaplan-Meier 分析法评估总生存率,采用对数秩方法比较组间生存率差异。T分期变化的显著性采用边际同质性检验进行评估:研究共纳入 136 例患者。预期肿瘤体积与实际肿瘤体积之间存在显著差异(P=0.01),T分期的相关变化也具有显著性(P=0.04)。在肿瘤分期较早的患者中,使用肿瘤体积(p=0.009)进行的生存分析结果优于使用直径(p=0.04)进行的生存分析结果:结论:基于肿瘤体积的T因子分期可作为NSCLC的另一种分期方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
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