Association between Mortality and Lung Low Attenuation Areas in NSCLC Treated by Surgery
Background: to test the association with overall survival (OS) of low attenuation areas (LAAs) quantified by staging computed tomography (CT) of patients who underwent radical surgery for nonsmall-cell lung cancer (NSCLC). Methods: patients who underwent radical surgery for NSCLC at our institution...
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MDPI AG
2023-06-01
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| Online Access: | https://www.mdpi.com/2075-1729/13/6/1377 |
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| author | Davide Colombi Ganiyat Adenike Ralitsa Adebanjo Rocco Delfanti Sara Chiesa Nicola Morelli Patrizio Capelli Cosimo Franco Emanuele Michieletti |
| author_facet | Davide Colombi Ganiyat Adenike Ralitsa Adebanjo Rocco Delfanti Sara Chiesa Nicola Morelli Patrizio Capelli Cosimo Franco Emanuele Michieletti |
| author_sort | Davide Colombi |
| collection | DOAJ |
| description | Background: to test the association with overall survival (OS) of low attenuation areas (LAAs) quantified by staging computed tomography (CT) of patients who underwent radical surgery for nonsmall-cell lung cancer (NSCLC). Methods: patients who underwent radical surgery for NSCLC at our institution between 1 January 2017 and 30 November 2021 were retrospectively evaluated. Patients who performed staging or follow-up CTs in other institutions, who received lung radiotherapy or chemotherapy, and who underwent previous lung surgery were excluded. At staging and 12-months follow-up CT, LAAs defined as voxels <−950 Hounsfield units, were extracted by software. The percent of LAAs relative to whole-lung volume (%LAAs) and the ratio between LAAs in the lobe to resect and whole-lung LAAs (%LAAs lobe ratio) were calculated. Cox proportional hazards regression analysis was used to test the association between OS and LAAs. Results: the final sample included 75 patients (median age 70 years, IQR 63–75 years; females 29/75, 39%). It identified a significant association with OS for pathological stage III (HR, 6.50; 95%CI, 1.11–37.92; <i>p</i> = 0.038), staging CT %LAAs ≥ 5% (HR, 7.27; 95%CI, 1.60–32.96; <i>p</i> = 0.010), and staging CT %LAA lobe ratio > 10% (HR, 0.24; 95%CI 0.05–0.94; <i>p</i> = 0.046). Conclusions: in patients with NSCLC who underwent radical surgery, a %LAAs ≥ 5% and a %LAA lobe ratio > 10% at staging CT are predictors, respectively, of shorter and longer OS. The LAA ratio to the whole lung at staging CT could be a critical factor to predict the overall survival of the NSCLC patients treated by surgery. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T02:14:06Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-0f167cbe6e1347cdb337fac73434faf72023-11-18T11:18:27ZengMDPI AGLife2075-17292023-06-01136137710.3390/life13061377Association between Mortality and Lung Low Attenuation Areas in NSCLC Treated by SurgeryDavide Colombi0Ganiyat Adenike Ralitsa Adebanjo1Rocco Delfanti2Sara Chiesa3Nicola Morelli4Patrizio Capelli5Cosimo Franco6Emanuele Michieletti7Department of Radiological Functions, Radiology Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, ItalyDepartment of Medicine and Surgery (DiMeC), Scienze Radiologiche, University of Parma, Via Gramsci 14, 43126 Parma, ItalyDepartment of Surgery, General Surgery Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, ItalyEmergency Department, Pulmonology Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, ItalyDepartment of Radiological Functions, Radiology Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, ItalyDepartment of Surgery, General Surgery Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, ItalyEmergency Department, Pulmonology Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, ItalyDepartment of Radiological Functions, Radiology Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, ItalyBackground: to test the association with overall survival (OS) of low attenuation areas (LAAs) quantified by staging computed tomography (CT) of patients who underwent radical surgery for nonsmall-cell lung cancer (NSCLC). Methods: patients who underwent radical surgery for NSCLC at our institution between 1 January 2017 and 30 November 2021 were retrospectively evaluated. Patients who performed staging or follow-up CTs in other institutions, who received lung radiotherapy or chemotherapy, and who underwent previous lung surgery were excluded. At staging and 12-months follow-up CT, LAAs defined as voxels <−950 Hounsfield units, were extracted by software. The percent of LAAs relative to whole-lung volume (%LAAs) and the ratio between LAAs in the lobe to resect and whole-lung LAAs (%LAAs lobe ratio) were calculated. Cox proportional hazards regression analysis was used to test the association between OS and LAAs. Results: the final sample included 75 patients (median age 70 years, IQR 63–75 years; females 29/75, 39%). It identified a significant association with OS for pathological stage III (HR, 6.50; 95%CI, 1.11–37.92; <i>p</i> = 0.038), staging CT %LAAs ≥ 5% (HR, 7.27; 95%CI, 1.60–32.96; <i>p</i> = 0.010), and staging CT %LAA lobe ratio > 10% (HR, 0.24; 95%CI 0.05–0.94; <i>p</i> = 0.046). Conclusions: in patients with NSCLC who underwent radical surgery, a %LAAs ≥ 5% and a %LAA lobe ratio > 10% at staging CT are predictors, respectively, of shorter and longer OS. The LAA ratio to the whole lung at staging CT could be a critical factor to predict the overall survival of the NSCLC patients treated by surgery.https://www.mdpi.com/2075-1729/13/6/1377nonsmall-cell lung cancerpulmonary emphysemasurvival |
| spellingShingle | Davide Colombi Ganiyat Adenike Ralitsa Adebanjo Rocco Delfanti Sara Chiesa Nicola Morelli Patrizio Capelli Cosimo Franco Emanuele Michieletti Association between Mortality and Lung Low Attenuation Areas in NSCLC Treated by Surgery Life nonsmall-cell lung cancer pulmonary emphysema survival |
| title | Association between Mortality and Lung Low Attenuation Areas in NSCLC Treated by Surgery |
| title_full | Association between Mortality and Lung Low Attenuation Areas in NSCLC Treated by Surgery |
| title_fullStr | Association between Mortality and Lung Low Attenuation Areas in NSCLC Treated by Surgery |
| title_full_unstemmed | Association between Mortality and Lung Low Attenuation Areas in NSCLC Treated by Surgery |
| title_short | Association between Mortality and Lung Low Attenuation Areas in NSCLC Treated by Surgery |
| title_sort | association between mortality and lung low attenuation areas in nsclc treated by surgery |
| topic | nonsmall-cell lung cancer pulmonary emphysema survival |
| url | https://www.mdpi.com/2075-1729/13/6/1377 |
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