Pleural contact decreases survival in clinical T1N0M0 lung cancer patients undergoing SBRT

Takahisa Eriguchi, Atsuya Takeda, Yuichiro Tsurugai, Naoko Sanuki, Yuichi Kibe, Yu Hara, Takeshi Kaneko, Masataka Taguri, Naoyuki Shigematsu

Research output: Contribution to journalArticle

Abstract

Background: Clinical staging, as used for patients treated with stereotactic body radiotherapy (SBRT) for early-stage lung cancer, inadequately accounts for pleural invasion, which is a pathologic criteria. Considering the current situation, we analyzed effects of relationships between tumors and the pleura on treatment outcomes of SBRT for early-stage lung cancer. Materials and methods: Among consecutive patients treated with SBRT between 2006 and 2017, we retrospectively identified non-small cell lung cancer patients with primary tumor diameters ≤4 cm and N0M0. The relationships between tumors and the pleura were investigated. The effects of these findings on treatment outcomes were analyzed. Results: We identified 386 patients which met the inclusion criteria. Among these patients, 323 patients were with tumors of 0.1–3.0 cm (T1-size), and 63 patients were with tumors of 3.1–4.0 cm (T2a-size). Among patients with T1-size tumors, 120, 134, and 23 had findings of pleural contact, pleural indentation, and pleural thickening, respectively. When we divided T1-size patients into 2 groups based on pleural contact (contact− or contact+), the 3-year cause-specific mortality and overall survival in patients with T1-size & contact+ were significantly worse than those in patients with T1-size & contact− (17.6% (95% confidence interval (CI), 10.7–25.9%) vs. 6.6% (95% CI, 3.5–11.1%), p < 0.01), and 58.2% (95% CI, 47.6–67.5%) vs. 77.6% (95% CI, 70.5–83.2%), p < 0.01). Local recurrence, regional recurrence, pleural cavity recurrence, and distant metastasis were associated with worse cause-specific mortality and overall survival. On multivariate analysis, pleural contact was associated with cause-specific mortality (hazard ratio (HR), 1.96; 95% CI, 1.09–3.52; p = 0.03) and overall survival (HR, 1.59; 95% CI, 1.08–2.34; p = 0.02). Conclusion: Pleural contact in clinical T1N0M0 lung cancer patients was associated with significantly worse survivals.

Original languageEnglish
Pages (from-to)191-198
Number of pages8
JournalRadiotherapy and Oncology
Volume134
DOIs
Publication statusPublished - 2019 May 1

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Radiosurgery
Lung Neoplasms
Survival
Confidence Intervals
Neoplasms
Pleura
Recurrence
Mortality
Pleural Cavity
Non-Small Cell Lung Carcinoma
Multivariate Analysis

Keywords

  • Clinical T stage
  • Pleural contact
  • Pleural invasion
  • SBRT

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Pleural contact decreases survival in clinical T1N0M0 lung cancer patients undergoing SBRT. / Eriguchi, Takahisa; Takeda, Atsuya; Tsurugai, Yuichiro; Sanuki, Naoko; Kibe, Yuichi; Hara, Yu; Kaneko, Takeshi; Taguri, Masataka; Shigematsu, Naoyuki.

In: Radiotherapy and Oncology, Vol. 134, 01.05.2019, p. 191-198.

Research output: Contribution to journalArticle

Eriguchi, T, Takeda, A, Tsurugai, Y, Sanuki, N, Kibe, Y, Hara, Y, Kaneko, T, Taguri, M & Shigematsu, N 2019, 'Pleural contact decreases survival in clinical T1N0M0 lung cancer patients undergoing SBRT', Radiotherapy and Oncology, vol. 134, pp. 191-198. https://doi.org/10.1016/j.radonc.2019.02.005
Eriguchi, Takahisa ; Takeda, Atsuya ; Tsurugai, Yuichiro ; Sanuki, Naoko ; Kibe, Yuichi ; Hara, Yu ; Kaneko, Takeshi ; Taguri, Masataka ; Shigematsu, Naoyuki. / Pleural contact decreases survival in clinical T1N0M0 lung cancer patients undergoing SBRT. In: Radiotherapy and Oncology. 2019 ; Vol. 134. pp. 191-198.
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abstract = "Background: Clinical staging, as used for patients treated with stereotactic body radiotherapy (SBRT) for early-stage lung cancer, inadequately accounts for pleural invasion, which is a pathologic criteria. Considering the current situation, we analyzed effects of relationships between tumors and the pleura on treatment outcomes of SBRT for early-stage lung cancer. Materials and methods: Among consecutive patients treated with SBRT between 2006 and 2017, we retrospectively identified non-small cell lung cancer patients with primary tumor diameters ≤4 cm and N0M0. The relationships between tumors and the pleura were investigated. The effects of these findings on treatment outcomes were analyzed. Results: We identified 386 patients which met the inclusion criteria. Among these patients, 323 patients were with tumors of 0.1–3.0 cm (T1-size), and 63 patients were with tumors of 3.1–4.0 cm (T2a-size). Among patients with T1-size tumors, 120, 134, and 23 had findings of pleural contact, pleural indentation, and pleural thickening, respectively. When we divided T1-size patients into 2 groups based on pleural contact (contact− or contact+), the 3-year cause-specific mortality and overall survival in patients with T1-size & contact+ were significantly worse than those in patients with T1-size & contact− (17.6{\%} (95{\%} confidence interval (CI), 10.7–25.9{\%}) vs. 6.6{\%} (95{\%} CI, 3.5–11.1{\%}), p < 0.01), and 58.2{\%} (95{\%} CI, 47.6–67.5{\%}) vs. 77.6{\%} (95{\%} CI, 70.5–83.2{\%}), p < 0.01). Local recurrence, regional recurrence, pleural cavity recurrence, and distant metastasis were associated with worse cause-specific mortality and overall survival. On multivariate analysis, pleural contact was associated with cause-specific mortality (hazard ratio (HR), 1.96; 95{\%} CI, 1.09–3.52; p = 0.03) and overall survival (HR, 1.59; 95{\%} CI, 1.08–2.34; p = 0.02). Conclusion: Pleural contact in clinical T1N0M0 lung cancer patients was associated with significantly worse survivals.",
keywords = "Clinical T stage, Pleural contact, Pleural invasion, SBRT",
author = "Takahisa Eriguchi and Atsuya Takeda and Yuichiro Tsurugai and Naoko Sanuki and Yuichi Kibe and Yu Hara and Takeshi Kaneko and Masataka Taguri and Naoyuki Shigematsu",
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T1 - Pleural contact decreases survival in clinical T1N0M0 lung cancer patients undergoing SBRT

AU - Eriguchi, Takahisa

AU - Takeda, Atsuya

AU - Tsurugai, Yuichiro

AU - Sanuki, Naoko

AU - Kibe, Yuichi

AU - Hara, Yu

AU - Kaneko, Takeshi

AU - Taguri, Masataka

AU - Shigematsu, Naoyuki

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background: Clinical staging, as used for patients treated with stereotactic body radiotherapy (SBRT) for early-stage lung cancer, inadequately accounts for pleural invasion, which is a pathologic criteria. Considering the current situation, we analyzed effects of relationships between tumors and the pleura on treatment outcomes of SBRT for early-stage lung cancer. Materials and methods: Among consecutive patients treated with SBRT between 2006 and 2017, we retrospectively identified non-small cell lung cancer patients with primary tumor diameters ≤4 cm and N0M0. The relationships between tumors and the pleura were investigated. The effects of these findings on treatment outcomes were analyzed. Results: We identified 386 patients which met the inclusion criteria. Among these patients, 323 patients were with tumors of 0.1–3.0 cm (T1-size), and 63 patients were with tumors of 3.1–4.0 cm (T2a-size). Among patients with T1-size tumors, 120, 134, and 23 had findings of pleural contact, pleural indentation, and pleural thickening, respectively. When we divided T1-size patients into 2 groups based on pleural contact (contact− or contact+), the 3-year cause-specific mortality and overall survival in patients with T1-size & contact+ were significantly worse than those in patients with T1-size & contact− (17.6% (95% confidence interval (CI), 10.7–25.9%) vs. 6.6% (95% CI, 3.5–11.1%), p < 0.01), and 58.2% (95% CI, 47.6–67.5%) vs. 77.6% (95% CI, 70.5–83.2%), p < 0.01). Local recurrence, regional recurrence, pleural cavity recurrence, and distant metastasis were associated with worse cause-specific mortality and overall survival. On multivariate analysis, pleural contact was associated with cause-specific mortality (hazard ratio (HR), 1.96; 95% CI, 1.09–3.52; p = 0.03) and overall survival (HR, 1.59; 95% CI, 1.08–2.34; p = 0.02). Conclusion: Pleural contact in clinical T1N0M0 lung cancer patients was associated with significantly worse survivals.

AB - Background: Clinical staging, as used for patients treated with stereotactic body radiotherapy (SBRT) for early-stage lung cancer, inadequately accounts for pleural invasion, which is a pathologic criteria. Considering the current situation, we analyzed effects of relationships between tumors and the pleura on treatment outcomes of SBRT for early-stage lung cancer. Materials and methods: Among consecutive patients treated with SBRT between 2006 and 2017, we retrospectively identified non-small cell lung cancer patients with primary tumor diameters ≤4 cm and N0M0. The relationships between tumors and the pleura were investigated. The effects of these findings on treatment outcomes were analyzed. Results: We identified 386 patients which met the inclusion criteria. Among these patients, 323 patients were with tumors of 0.1–3.0 cm (T1-size), and 63 patients were with tumors of 3.1–4.0 cm (T2a-size). Among patients with T1-size tumors, 120, 134, and 23 had findings of pleural contact, pleural indentation, and pleural thickening, respectively. When we divided T1-size patients into 2 groups based on pleural contact (contact− or contact+), the 3-year cause-specific mortality and overall survival in patients with T1-size & contact+ were significantly worse than those in patients with T1-size & contact− (17.6% (95% confidence interval (CI), 10.7–25.9%) vs. 6.6% (95% CI, 3.5–11.1%), p < 0.01), and 58.2% (95% CI, 47.6–67.5%) vs. 77.6% (95% CI, 70.5–83.2%), p < 0.01). Local recurrence, regional recurrence, pleural cavity recurrence, and distant metastasis were associated with worse cause-specific mortality and overall survival. On multivariate analysis, pleural contact was associated with cause-specific mortality (hazard ratio (HR), 1.96; 95% CI, 1.09–3.52; p = 0.03) and overall survival (HR, 1.59; 95% CI, 1.08–2.34; p = 0.02). Conclusion: Pleural contact in clinical T1N0M0 lung cancer patients was associated with significantly worse survivals.

KW - Clinical T stage

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KW - Pleural invasion

KW - SBRT

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