Prediction of surgical outcome by tumor volume doubling time via stereo imaging software in early non-small cell lung cancer

Abstract

Abstract Background: Volume doubling time (VDT) has been proven to be a powerful predictor of lung cancer progression. In non-small cell lung cancer (NSCLC) patients receiving sublobar resection, the discussion of correlation between VDT and surgery was absent. We propose to investigate the surgical outcomes according to VDT, to see if it could serve as a prognostic predictor preoperatively. Methods: We retrospectively studied 96 NSCLC patients post sublobar resection from 2012 to 2018, collecting two chest CT scans preoperatively of each case and calculating VDT. The receiver operating characteristic curve was constructed to identify the optimal cut-off point of VDTs as 133 days. We divided patients into two groups: VDT < 133 days (n=22) and VDT ≥ 133 days (n=74). Univariable and multivariable analyses were performed for comparative purposes. Results: Clinical characteristics including gender, smoking history, chronic obstructive pulmonary disease, epidermal growth factor receptor gene mutation, tumor stage, and histological type were significantly different between the two groups. Univariable and multivariable analyses revealed that the consolidation and tumor diameter ratio was the factor of overall survival (OS), and VDT was the only factor of disease-free survival (DFS). The 5-year OS rates of patients with VDTs ≥ 133 days and VDTs < 133 days, respectively, were 89.9% and 71.9% (p = 0.003), and the 5-year DFS rates were 95.9% and 61.5% (p = 0.002). Conclusions: As the VDT serves as a powerful prognostic predictor and provides an essential role in planning surgical procedures, the evaluation of VDT preoperatively is highly suggested.