Abstract
Background In the eighth edition of the TNM classification, the lung tumors that have the same
solid components are categorized either as part-solid or pure-solid tumors. However,
this is debatable since the tumors in the same T component categories were evaluated
without considering this categorization, and was based on a more malignant behavior
and a poorer prognosis of pure-solid tumors. The aim of this study was to investigate
and compare the prognosis between part-solid and pure-solid tumors.
Methods We retrospectively analyzed 530 patients who were diagnosed with clinical-T1a-cN0M0
non–small-cell lung cancer (NSCLC) and were treated surgically. The subjects were
divided into part-solid and pure-solid tumor groups using thin-section computed tomography.
The prognosis was compared between the groups.
Results Although relapse-free survival (RFS) was significantly shorter in the pure-solid
tumor group (p = 0.016), no significant differences were observed in the overall survival (OS) between
the two groups (p = 0.247). In 137 propensity score–matched pairs, including variables such as age,
gender, Brinkman index, body mass index, forced expiratory volume in 1 second/forced
vital capacity, Charlson comorbidity index, carcinoembryonic antigen levels, clinical-T
status, surgical procedure, and extent of surgery, no significant differences were
seen in the RFS and OS between the two groups (p = 0.709 and p = 0.517, respectively).
Conclusion In the eighth edition of the TNM classification of clinical-T1a-cN0M0 NSCLC, the
prognosis of part-solid and pure-solid tumors showed no significant differences. Solid
component size of the tumor is considered important prognostic factor in early-stage
NSCLC.
Keywords
surgery - lung cancer treatment - lung cancer - diagnosis - VATS
