Predictive value of radiological features on spread through air space in stage cIA lung adenocarcinoma

• DOI: 10.21037/jtd-20-1820
• Publication Date: 2020-11-25T04:05:10Z
• Authors: Zhenrong Zhang; Zhan Liu; Hongxiang Feng; Fei Xiao; Weipeng Shao; Chaoyang Liang; Hongliang Sun; Xinlei Gu; Deruo Liu
• Keywords: Lymphovascular invasion

Spread through air space (STAS) is a risk factor for disease recurrence in patients with stage IA lung adenocarcinoma (LUAD) who undergo limited resection. Preoperative prediction of STAS could help intraoperative surgical decision-making small LUAD patients. The aim the study was to evaluate predictive value radiological features on cIA LUAD.A case-control designed retrospective analysis underwent curative surgery clinical tumor size ≤3 cm. Univariable and multivariable analyses were used identify independent factors STAS. predicted probability calculated by specific formula. Receiver operating characteristic (ROC) curves determine cut-off appropriate specificity while maintaining high sensitivity positivity.STAS frequently observed acinar predominant (P<0.001), micropapillary (P<0.001) solid tumors significantly associated larger pT presence component lymphovascular invasion (LVI) visceral pleura (VPI) both N1 N2 lymph node metastasis ALK rearrangement (P<0.001). STAS-positivity cavitation (P=0.047), lobulation (P=0.009), bronchogram vascular convergence (P=0.016) also greater maximum diameter area consolidation/tumor ratio (CTR) disappearance (TDR) computed tomography (CT) Multivariable showed that (P=0.042), (P=0.015), (P=0.022) CTR ROC curve under (AUC) 0.726 model predicting STAS, 95.2% 36.8%, respectively.STAS-positive bronchogram, diameter, CTR. These predict excellent but inferior specificity.