Is using a consolidation tumor ratio 0.5 as criterion feasible in daily practice? Evaluation of interobserver measurement variability of consolidation tumor ratio of lung cancer less than 3 cm in size.
consolidation tumor ratio
interobserver variability
lung cancer classification
Journal
Thoracic cancer
ISSN: 1759-7714
Titre abrégé: Thorac Cancer
Pays: Singapore
ID NLM: 101531441
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
revised:
28
08
2022
received:
27
06
2022
accepted:
30
08
2022
pubmed:
5
10
2022
medline:
4
11
2022
entrez:
4
10
2022
Statut:
ppublish
Résumé
Consolidation tumor ratio (CTR) calculated as the ratio of the tumor consolidation diameter to the tumor maximum diameter on thin-section computed tomography (CT) of lung cancer has been reported as an important prognostic factor. It has also been used for treatment decision-making. This study aimed to investigate the interobserver variability of CTR measurements on preoperative CT and propose a clinically useful CTR-based classification criterion. We enrolled 119 patients who underwent surgery for suspected or diagnosed small-sized lung cancer (≤3.0 cm in diameter). Nine doctors reviewed preoperative CT scans to measure CTR. Interobserver variability of CTR measurements was evaluated using the coefficient of variation (CV) and Fleiss' κ. The prognostic effect of the CTR-based classification was assessed using the Kaplan-Meier method. Interobserver variability of CTR measurement was the highest for tumors with the lowest CTR (CTR = 0); it decreased as CTR increased and reached a plateaued level of low variability (CV <0.5) at CTR of 0.5. We proposed a three-group classification based on the findings of CTR interobserver variability (CTR < 0.5, 0.5 ≤ CTR < 1, and CTR = 1). Interobserver agreement of the judgment of the CTR-based classification was excellent (Fleiss' κ = 0.81). The classification significantly stratified patient prognosis (p < 0.001, 5-year overall survival rates with CTR < 0.5, 0.5 ≤ CTR < 1, and CTR = 1 were 100, 88, and 73.8%, respectively). CTR 0.5 is a clinically relevant and helpful cutoff for treatment decision-making in patients with early-stage lung cancer based on high interobserver agreement and good prognostic stratification.
Sections du résumé
BACKGROUND
Consolidation tumor ratio (CTR) calculated as the ratio of the tumor consolidation diameter to the tumor maximum diameter on thin-section computed tomography (CT) of lung cancer has been reported as an important prognostic factor. It has also been used for treatment decision-making. This study aimed to investigate the interobserver variability of CTR measurements on preoperative CT and propose a clinically useful CTR-based classification criterion.
METHODS
We enrolled 119 patients who underwent surgery for suspected or diagnosed small-sized lung cancer (≤3.0 cm in diameter). Nine doctors reviewed preoperative CT scans to measure CTR. Interobserver variability of CTR measurements was evaluated using the coefficient of variation (CV) and Fleiss' κ. The prognostic effect of the CTR-based classification was assessed using the Kaplan-Meier method.
RESULTS
Interobserver variability of CTR measurement was the highest for tumors with the lowest CTR (CTR = 0); it decreased as CTR increased and reached a plateaued level of low variability (CV <0.5) at CTR of 0.5. We proposed a three-group classification based on the findings of CTR interobserver variability (CTR < 0.5, 0.5 ≤ CTR < 1, and CTR = 1). Interobserver agreement of the judgment of the CTR-based classification was excellent (Fleiss' κ = 0.81). The classification significantly stratified patient prognosis (p < 0.001, 5-year overall survival rates with CTR < 0.5, 0.5 ≤ CTR < 1, and CTR = 1 were 100, 88, and 73.8%, respectively).
CONCLUSIONS
CTR 0.5 is a clinically relevant and helpful cutoff for treatment decision-making in patients with early-stage lung cancer based on high interobserver agreement and good prognostic stratification.
Identifiants
pubmed: 36193574
doi: 10.1111/1759-7714.14653
pmc: PMC9626346
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3018-3024Informations de copyright
© 2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
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