Honeycomb lung is a major risk factor for preoperative radiological tumor size underestimation in patients with primary lung cancer

Journal of Thoracic Disease

article

Hisato Ishizawa¹  Yasushi Matsuda¹  Yoshiharu Ohno²  Eiko Sakurai³  Atsuhiko Ota⁴  Hidekazu Hattori²  Tetsuya Tsukamoto³  Masaaki Matsunaga⁴  Hiroshi Kawai¹  Yamato Suzuki¹  Hiromitsu Nagano¹  Takahiro Negi⁵  Daisuke Tochii⁵  Sachiko Tochii⁵  Takashi Suda⁵  Yasushi Hoshikawa¹ 

[1] Department of Thoracic Surgery, Fujita Health University;Department of Radiology, Fujita Health University;Department of Diagnostic Pathology, Fujita Health University;Department of Public Health, Fujita Health University;Department of Thoracic Surgery, Fujita Health University Okazaki Medical Center

关键词: Conclusions Honeycomb lung adjacent to the tumor is a major risk factor for preoperative radiological tumor size underestimation in patients with lung cancer.;    Idiopathic interstitial pneumonia;    underestimation;    tumor size;    honeycomb lung;    honeycombing;   

DOI  :  10.21037/jtd-22-1115

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: Lung cancer frequently occurs in lungs with background idiopathic interstitial pneumonias (IIPs). Limited resection is often selected to treat lung cancer in patients with IIPs in whom respiratory function is already compromised. However, accurate surgical margins are essential for curative resection; underestimating these margins is a risk for residual lung cancer after surgery. We aimed to investigate the findings of lung fields adjacent to cancer segments affect the estimation of tumor size on computed tomography compared with the pathological specimen. Methods: This analytical observational study retrospectively investigated 896 patients with lung cancer operated on at Fujita Health University from January 2015 to June 2020. The definition of underestimation was a ≥10 mm difference between the radiological and pathological maximum sizes of the tumor. Results: The lung tumors were in 15 honeycomb, 30 reticulated, 207 emphysematous, and 628 normal lungs. The ratio of underestimation in honeycomb lungs was 33.3% compared to 7.4% without honeycombing (P=0.004). Multivariate analysis showed that honeycombing was a significant risk factor for tumor size underestimation. A Bland-Altman plot represented wide 95% limits of agreement, −40.8 to 70.2 mm, between the pathological and radiological maximum tumor sizes in honeycomb lungs.

【 授权许可】

Unknown