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Ann Thorac Surg. 2015 Mar;99(3):968-74. doi: 10.1016/j.athoracsur.2014.10.040. Epub 2015 Jan 23.

Surgically resected solitary cavitary lung adenocarcinoma: association between clinical, pathologic, and radiologic findings and prognosis.

Author information

1
Division of Pathology, National Cancer Center Hospital, Tokyo, Japan; Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan; Department of Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
2
Division of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
3
Division of Pathology, National Cancer Center Hospital, Tokyo, Japan.
4
Department of Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
5
Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
6
Division of Pathology, National Cancer Center Hospital, Tokyo, Japan. Electronic address: ktsuta@ncc.go.jp.

Abstract

BACKGROUND:

The incidence of cavitary lung adenocarcinoma has recently increased; despite this, little is known about its clinical features and prognosis. We, therefore, evaluated the clinicopathologic features and prognosis of this malignancy.

METHODS:

Between 1998 and 2007, 2,316 patients without preoperative chemotherapy or radiation therapy underwent surgical resection for primary lung adenocarcinoma. Among these cases, 143 (6.2%) were diagnosed as having cavitary adenocarcinoma based on high-resolution computed tomography scans and were enrolled in our study.

RESULTS:

Cavitary adenocarcinoma occurred more frequently in patients who were male (p < 0.001); who had a smoking history (p < 0.001), larger tumor size (p < 0.001), a tumor in the lower lobe (p < 0.001), lymph node metastasis (p = 0.02), advanced tumor stage (p = 0.04), postoperative recurrence (p < 0.01), and a papillary (p = 0.02) or solid predominant tumor pattern (p < 0.01); and who had vascular (p < 0.001), lymphatic (p = 0.04), or pleural invasion (p < 0.01). Kaplan-Meier analysis revealed that the overall and recurrence-free survival of patients with cavitary adenocarcinoma was significantly shorter than that of patients with noncavitary adenocarcinoma (p < 0.001). Multivariate analysis revealed that cavity formation was an independent prognostic factor in adenocarcinoma (p = 0.028).

CONCLUSIONS:

Cavitary adenocarcinoma has worse prognostic clinicopathologic characteristics than noncavitary adenocarcinoma. Based on this finding, cavitary and noncavitary adenocarcinoma tumors should be considered separate entities.

[Indexed for MEDLINE]

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