Radiomic score is prognostic in clinical stage I lung adenocarcinoma ≤2 cm undergoing surgery.

Autor:	Park JA; Department of Surgery, INOVA Fairfax Medical Center, Fairfax, VA, USA., Pham D; University of Virginia School of Medicine, Charlottesville, VA, USA., Wang H; Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC, USA., Khandhar S; Department of Surgery, Virginia Cancer Specialists, Fairfax, VA, USA., Weyant MJ; Department of Surgery, Thoracic Surgery, INOVA Fairfax Medical Center, Fairfax, VA, USA., Suzuki K; Department of Surgery, Thoracic Surgery, INOVA Fairfax Medical Center, Fairfax, VA, USA.
Jazyk:	angličtina
Zdroj:	Journal of thoracic disease [J Thorac Dis] 2024 Oct 31; Vol. 16 (10), pp. 6475-6482. Date of Electronic Publication: 2024 Oct 30.
DOI:	10.21037/jtd-24-923
Abstrakt:	Background: As sub-lobar resection becomes acceptable for lung cancer ≤2 cm, a preoperative marker of tumor aggressiveness to choose an appropriate extent of resection becomes necessary. We sought to assess the utility of Computer-Aided Nodule Assessment and Risk Yield (CANARY), a validated radiomic tool, in clinical stage I adenocarcinoma ≤2 cm. Methods: We performed a retrospective review of resected lung cancer patients from 2016-2022. Our eligibility criteria included clinical stage I adenocarcinoma, availability of pre-operative computed tomography (CT) imaging, and a lesion size of ≤2 cm. Preoperative imaging was input into the CANARY program, and this was then used to categorize each lesion into good, intermediate, and poor. Kaplan-Meier curve was used to compare the recurrence-free survival (RFS). Descriptive statistics and log-rank tests were conducted to compare RFS between risk groups. Results: Study population (n=134) had a median age of 68.6 and follow up of 2.9 years. By CANARY profile, 29 patients (21.6%) were good risk, 52 (38.8%) intermediate, and 53 (39.6%) poor. By procedure, 52 patients (38.8%) received wedge resections. Overall, the 3-year RFS was 96.3%, 92.0%, and 72.7% for patients with good, intermediate, and poor risks, respectively. There was a statistically significant difference in RFS between each risk group (χ 2 =12.6, P=0.002). Patients with poor risk were associated with a significantly increased risk of recurrence relative to those with good/intermediate risks [hazard ratio (HR) =5.7, 95% confidence interval (CI): 1.9-17.5]. Conclusions: Poor risk on CANARY analysis is significantly associated with increased risk of recurrence after resection in clinical stage I adenocarcinoma lesions ≤2 cm. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-24-923/coif). S.K. has consulting roles with Medtronic, AstraZeneca, Bristol Myers Squibb, and Roche, none of which are pertinent for the current manuscript. The other authors have no conflicts of interest to declare. (2024 AME Publishing Company. All rights reserved.)
Databáze:	MEDLINE
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