1
|
Wu J, Zhuang W, Chen R, Xu H, Li Z, Lan Z, Xia X, He Z, Li S, Deng C, Xu W, Shi Q, Tang Y, Qiao G. Impact of surgery versus follow-up on psychological distress in patients with indeterminate pulmonary nodules: A prospective observational study. Qual Life Res 2025; 34:1167-1177. [PMID: 39812961 DOI: 10.1007/s11136-024-03876-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2024] [Indexed: 01/16/2025]
Abstract
PURPOSE To investigate whether surgery is more effective than follow-up in reducing psychological distress for patients with observable indeterminate pulmonary nodules (IPNs) and to assess if psychological distress can serve as a potential surgical indication for IPNs. METHODS This prospective observational study included 341 patients with abnormal psychometric results, as measured by the Hospital Anxiety and Depression Scale (HADS). Of these, 262 patients opted for follow-up and 79 chose surgery. Initial psychological assessments (HADS1) were conducted at enrollment following nodule detection, with a second assessment (HADS2) one year later. A comparative analysis of dynamic psychological changes (ΔHADS: HADS2-HADS1) between the follow-up and surgical groups was performed. RESULTS Both groups showed reductions in HADS-A [- 3 (IQR, - 7 to - 1) for follow-up and - 3 (IQR, - 6 to - 1) for surgery] and HADS-D scores [- 2 (IQR, - 4 to 0) for follow-up and - 3 (IQR, - 7 to 0) for surgery]. Univariate analysis revealed that the surgical group had a significantly greater reduction in HADS-D scores compared to the follow-up group (Z = - 2.08, P = 0.037), but there were no significant differences in the changes in HADS-A scores between the groups (Z = - 1.04, P = 0.300). However, in multivariable analysis, surgery did not significantly improve the alleviation of depressive symptoms compared to follow-up (β = - 0.72, 95% CI: - 1.57 to 0.14, P = 0.101). Within the surgical group, female patients reported less relief from anxiety than male patients (Z = - 2.32, P = 0.021), and symptomatic patients experienced less relief from both anxiety (Z = - 2.14, P = 0.032) and depression (Z = - 3.01, P = 0.003). CONCLUSIONS Surgery does not provide additional psychological benefits over follow-up. This study does not support using psychological distress as a criterion for surgical intervention in IPNs from a psychological perspective. Trial registry ClinicalTrials.gov (NCT04857333).
Collapse
Affiliation(s)
- Junhan Wu
- Shantou University Medical College, Shantou, 515041, China
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, China
| | - Weitao Zhuang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Rixin Chen
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, China
| | - Haijie Xu
- Shantou University Medical College, Shantou, 515041, China
| | - Zijie Li
- Shantou University Medical College, Shantou, 515041, China
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, China
| | - Zihua Lan
- Shantou University Medical College, Shantou, 515041, China
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, China
| | - Xin Xia
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, China
| | - Zhe He
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510000, China
| | - Shaopeng Li
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510000, China
- Department of Thoracic Surgery, The Third People's Hospital of Shenzhen, Shenzhen, 518000, China
| | - Cheng Deng
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, China
| | - Wei Xu
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Qiuling Shi
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yong Tang
- Department of Thoracic Surgery, Shenzhen Nanshan People's Hospital, Shenzhen, 518052, China.
| | - Guibin Qiao
- Shantou University Medical College, Shantou, 515041, China.
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510000, China.
- Department of Thoracic Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.
| |
Collapse
|
2
|
Zhang L, Shao Y, Chen G, Tian S, Zhang Q, Wu J, Bai C, Yang D. An artificial intelligence-assisted diagnostic system for the prediction of benignity and malignancy of pulmonary nodules and its practical value for patients with different clinical characteristics. Front Med (Lausanne) 2023; 10:1286433. [PMID: 38196835 PMCID: PMC10774219 DOI: 10.3389/fmed.2023.1286433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
Objectives This study aimed to explore the value of an artificial intelligence (AI)-assisted diagnostic system in the prediction of pulmonary nodules. Methods The AI system was able to make predictions of benign or malignant nodules. 260 cases of solitary pulmonary nodules (SPNs) were divided into 173 malignant cases and 87 benign cases based on the surgical pathological diagnosis. A stratified data analysis was applied to compare the diagnostic effectiveness of the AI system to distinguish between the subgroups with different clinical characteristics. Results The accuracy of AI system in judging benignity and malignancy of the nodules was 75.77% (p < 0.05). We created an ROC curve by calculating the true positive rate (TPR) and the false positive rate (FPR) at different threshold values, and the AUC was 0.755. Results of the stratified analysis were as follows. (1) By nodule position: the AUC was 0.677, 0.758, 0.744, 0.982, and 0.725, respectively, for the nodules in the left upper lobe, left lower lobe, right upper lobe, right middle lobe, and right lower lobe. (2) By nodule size: the AUC was 0.778, 0.771, and 0.686, respectively, for the nodules measuring 5-10, 10-20, and 20-30 mm in diameter. (3) The predictive accuracy was higher for the subsolid pulmonary nodules than for the solid ones (80.54 vs. 66.67%). Conclusion The AI system can be applied to assist in the prediction of benign and malignant pulmonary nodules. It can provide a valuable reference, especially for the diagnosis of subsolid nodules and small nodules measuring 5-10 mm in diameter.
Collapse
Affiliation(s)
- Lichuan Zhang
- Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yue Shao
- Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Guangmei Chen
- Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Simiao Tian
- Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Qing Zhang
- Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Jianlin Wu
- Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Chunxue Bai
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Shanghai Respiratory Research Institution, Shanghai, China
| | - Dawei Yang
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Shanghai Respiratory Research Institution, Shanghai, China
| |
Collapse
|
3
|
Ren XD, Su N, Sun XG, Li WM, Li J, Li BW, Li RX, Lv J, Xu QY, Kong WL, Huang Q. Advances in liquid biopsy-based markers in NSCLC. Adv Clin Chem 2023; 114:109-150. [PMID: 37268331 DOI: 10.1016/bs.acc.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Lung cancer is the second most-frequently occurring cancer and the leading cause of cancer-associated deaths worldwide. Non-small cell lung cancer (NSCLC), the most common type of lung cancer is often diagnosed in middle or advanced stages and have poor prognosis. Diagnosis of disease at an early stage is a key factor for improving prognosis and reducing mortality, whereas, the currently used diagnostic tools are not sufficiently sensitive for early-stage NSCLC. The emergence of liquid biopsy has ushered in a new era of diagnosis and management of cancers, including NSCLC, since analysis of circulating tumor-derived components, such as cell-free DNA (cfDNA), circulating tumor cells (CTCs), cell-free RNAs (cfRNAs), exosomes, tumor-educated platelets (TEPs), proteins, and metabolites in blood or other biofluids can enable early cancer detection, treatment selection, therapy monitoring and prognosis assessment. There have been great advances in liquid biopsy of NSCLC in the past few years. Hence, this chapter introduces the latest advances on the clinical application of cfDNA, CTCs, cfRNAs and exosomes, with a particular focus on their application as early markers in the diagnosis, treatment and prognosis of NSCLC.
Collapse
Affiliation(s)
- Xiao-Dong Ren
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Ning Su
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Xian-Ge Sun
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Wen-Man Li
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Jin Li
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Bo-Wen Li
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Ruo-Xu Li
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Jing Lv
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Qian-Ying Xu
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Wei-Long Kong
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Qing Huang
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China.
| |
Collapse
|
4
|
Li M, Zhang C, Deng S, Li L, Liu S, Bai J, Xu Y, Guan Y, Xia X, Sun L, Carbone DP, Hu C. Lung cancer-associated T cell repertoire as potential biomarker for early detection of stage I lung cancer. Lung Cancer 2021; 162:16-22. [PMID: 34649105 DOI: 10.1016/j.lungcan.2021.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/15/2021] [Accepted: 09/20/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Early detection of lung cancer in asymptomatic patients remains challenging, especially for stage I. Considering the substantial interaction with tumor immunogenicity, we hypothesized that lung cancer-associated TCR (LC-aTCR) may serve as potential biomarker in early detection of stage I lung cancer. METHODS Individuals who received low-dose computed tomography (LDCT) screening were enrolled in the study. Surgical tissues and peripheral blood specimens were collected and performed with DNA-based T cell repertoire (TCR) sequencing. The motif-based algorithm was used to deconstruct specific lung cancer-associated TCRs (LC-aTCRs). RESULTS A total of 146 individuals participating in the real-world LDCT screening project were enrolled in this study, including 52 patients with pathologically-confirmed stage I lung cancer and 94 non-cancer controls. We developed a motif-based algorithm to define 80 LC-aTCRs in the training cohort. Moreover, in the validation cohort, high sensitivity and specificity was showed in stage I lung cancer with 72% and 91% respectively, and the AUC of the ROC curve was 0.91 (95% CI: 0.85 ∼ 0.96). CONCLUSION This work provides inspiration for stage I lung cancer detection by using blood TCR profiling data. The combination of TCR-based assay and routine screening deserves further testing in larger cohorts.
Collapse
Affiliation(s)
- Min Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, China; Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China; James Cancer Center, The Ohio State University Medical Center, Columbus, USA
| | | | - Shichao Deng
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, China
| | - Li Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, China
| | - Shiqing Liu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, China; Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
| | - Jing Bai
- Geneplus-Beijing Institute, Beijing, China
| | - Yaping Xu
- Geneplus-Beijing Institute, Beijing, China
| | | | | | - Lunquan Sun
- Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Changsha, China
| | - David P Carbone
- James Cancer Center, The Ohio State University Medical Center, Columbus, USA
| | - Chengping Hu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, China; Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Changsha, China.
| |
Collapse
|
5
|
Abstract
Parallel and often unrelated developments in health care and technology have all been necessary to bring about early detection of lung cancer and the opportunity to decrease mortality from lung cancer through early detection of the disease by computed tomography. Lung cancer screening programs provide education for patients and clinicians, support smoking cessation as primary prevention for lung cancer, and facilitate health care for tobacco-associated diseases, including cardiovascular and chronic lung diseases. Guidelines for lung cancer screening will need to continue to evolve as additional risk factors and screening tests are developed. Data collection from lung cancer screening programs is vital to the further development of fiscally responsible guidelines to increase detection of lung cancer, which may include small groups with elevated risk for reasons other than tobacco exposure.
Collapse
Affiliation(s)
- Francine L Jacobson
- Departments of Radiology and Thoracic Surgery, Brigham and Women's Hospital, Boston, MA 02115; ,
| | - Michael T Jaklitsch
- Departments of Radiology and Thoracic Surgery, Brigham and Women's Hospital, Boston, MA 02115; ,
| |
Collapse
|
6
|
Ku JY, Kim S, Hong SB, Lee JG, Lee CH, Choi SH, Ha HK. Prognostic indicators of pulmonary metastasis in patients with renal cell carcinoma who have undergone radical nephrectomy. Oncol Lett 2019; 17:3009-3016. [PMID: 30854079 DOI: 10.3892/ol.2019.9912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 11/26/2018] [Indexed: 12/21/2022] Open
Abstract
The aim of the present study was to validate prognostic indicators of pulmonary metastasis in patients with renal cell carcinoma (RCC) that have undergone nephrectomy treatment. The data from 356 patients who underwent nephrectomy were investigated and subsequently divided into 2 groups, according to the pulmonary metastasis status. The risk factors for pulmonary metastasis were examined in all patients. In the subgroup analysis, the risk factors were additionally verified in patients with pulmonary nodules using univariate and multivariate logistic regression analyses. The status of pulmonary nodules and pulmonary metastasis were confirmed through preoperative chest radiography by two radiologists. Pulmonary metastasis was observed in 33 (9.3%) patients with a median follow-up time of 54.4 months (interquartile range, 38.8-71.8). Patients with pulmonary nodules indicated significantly increased rates of pulmonary metastasis, compared with patients without pulmonary nodules (24.2 vs. 6.1%; P<0.001). In multivariate analysis, the presence of pulmonary nodules [hazard ratio (HR)=3.15; P=0.0262], albumin (HR=0.42; P=0.0490) and pTstage (HR=3.63; P=0.0475) were indicated to be independent prognostic markers for pulmonary metastasis. In subgroup analysis, pTstage was the only independent prognostic indicator for pulmonary metastasis in these patients (HR=9.81; P=0.0033). In patients with RCC, the presence of pulmonary nodules was associated with pulmonary metastasis. Furthermore, pTstage is a negative prognostic indicator in patients with pulmonary nodules. Therefore, a chest radiologic short-term follow-up is required for these patients.
Collapse
Affiliation(s)
- Ja Yoon Ku
- Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea
| | - Suk Kim
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea
| | - Seung Baek Hong
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea
| | - Jong Geun Lee
- Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju 63241, Republic of Korea
| | - Chan Ho Lee
- Department of Urology, Busan Paik Hospital, College of Medicine, Inje University, Busan 47392, Republic of Korea
| | - Seock Hwan Choi
- Department of Urology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Hong Koo Ha
- Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea
| |
Collapse
|
7
|
Du Y, Zhao Y, Sidorenkov G, de Bock GH, Cui X, Huang Y, Dorrius MD, Rook M, Groen HJM, Heuvelmans MA, Vliegenthart R, Chen K, Xie X, Liu S, Oudkerk M, Ye Z. Methods of computed tomography screening and management of lung cancer in Tianjin: design of a population-based cohort study. Cancer Biol Med 2019; 16:181-188. [PMID: 31119059 PMCID: PMC6528449 DOI: 10.20892/j.issn.2095-3941.2018.0237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective European lung cancer screening studies using computed tomography (CT) have shown that a management protocol based on measuring lung nodule volume and volume doubling time (VDT) is more specific for early lung cancer detection than a diameter-based protocol. However, whether this also applies to a Chinese population is unclear. The aim of this study is to compare the diagnostic performance of a volume-based protocol with a diameter-based protocol for lung cancer detection and optimize the nodule management criteria for a Chinese population. Methods This study has a population-based, prospective cohort design and includes 4000 participants from the Hexi district of Tianjin, China. Participants will undergo low-dose chest CT at baseline and after 1 year. Initially, detected lung nodules will be evaluated for diameter and managed according to a routine diameter-based protocol (Clinical Practice Guideline in Oncology for Lung Cancer Screening, Version 2.2018). Subsequently, lung nodules will be evaluated for volume and management will be simulated according to a volume-based protocol and VDT (a European lung nodule management protocol). Participants will be followed up for 4 years to evaluate lung cancer incidence and mortality. The primary outcome is the diagnostic performance of the European volume-based protocol compared to diameter-based management regarding lung nodules detected using low-dose CT. Results The diagnostic performance of volume- and diameter-based management for lung nodules in a Chinese population will be estimated and compared. Conclusions Through the study, we expect to improve the management of lung nodules and early detection of lung cancer in Chinese populations.
Collapse
Affiliation(s)
- Yihui Du
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands.,Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Yingru Zhao
- Department of Radiology,Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Grigory Sidorenkov
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands.,Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Xiaonan Cui
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands.,Department of Radiology,Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Yubei Huang
- Department of Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Monique D Dorrius
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands.,Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Mieneke Rook
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands.,Department of Radiology, Martini Hospital, Groningen 9728 NT, The Netherlands
| | - Harry J M Groen
- Department of Pulmonary Diseases, University of Groningen, University Medical Centre Groningen, Groningen 9713 GZ, The Netherlands
| | - Marjolein A Heuvelmans
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands.,Medisch Spectrum Twente, Department of Pulmonology, Enschede 7512 KZ, The Netherlands
| | - Rozemarijn Vliegenthart
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands.,Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Kexin Chen
- Department of Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Xueqian Xie
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Shiyuan Liu
- Department of Radiology, Shanghai Changzheng Hospital, The Second Military Medical University Shanghai, Shanghai 200003, China
| | - Matthijs Oudkerk
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Zhaoxiang Ye
- Department of Radiology,Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| |
Collapse
|
8
|
Radiation Therapy in Non-small-Cell Lung Cancer. Radiat Oncol 2019. [DOI: 10.1007/978-3-319-52619-5_34-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
9
|
Schreuder A, Schaefer-Prokop CM, Scholten ET, Jacobs C, Prokop M, van Ginneken B. Lung cancer risk to personalise annual and biennial follow-up computed tomography screening. Thorax 2018; 73:thoraxjnl-2017-211107. [PMID: 29602813 DOI: 10.1136/thoraxjnl-2017-211107] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND All lung cancer CT screening trials used fixed follow-up intervals, which may not be optimal. We developed new lung cancer risk models for personalising screening intervals to 1 year or 2 years, and compared these with existing models. METHODS We included participants in the CT arm of the National Lung Screening Trial (2002-2010) who underwent a baseline scan and a first annual follow-up scan and were not diagnosed with lung cancer in the first year. True and false positives and the area under the curve of each model were calculated. Internal validation was performed using bootstrapping. RESULTS Data from 24 542 participants were included in the analysis. The accuracy was 0.785, 0.693, 0.697, 0.666 and 0.727 for the polynomial, patient characteristics, diameter, Patz and PanCan models, respectively. Of the 24 542 participants included, 174 (0.71%) were diagnosed with lung cancer between the first and the second annual follow-ups. Using the polynomial model, 2558 (10.4%, 95% CI 10.0% to 10.8%), 7544 (30.7%, 30.2% to 31.3%), 10 947 (44.6%, 44.0% to 45.2%), 16 710 (68.1%, 67.5% to 68.7%) and 20 023 (81.6%, 81.1% to 92.1%) of the 24 368 participants who did not develop lung cancer in the year following the first follow-up screening round could have safely skipped it, at the expense of delayed diagnosis of 0 (0.0%, 0.0% to 2.7%), 8 (4.6%, 2.2% to 9.2%), 17 (9.8%, 6.0% to 15.4%), 44 (25.3%, 19.2% to 32.5%) and 70 (40.2%, 33.0% to 47.9%) of the 174 lung cancers, respectively. CONCLUSIONS The polynomial model, using both patient characteristics and baseline scan morphology, was significantly superior in assigning participants to 1-year or 2-year screening intervals. Implementing personalised follow-up intervals would enable hundreds of participants to skip a screening round per lung cancer diagnosis delayed.
Collapse
Affiliation(s)
- Anton Schreuder
- Department of Radiology and Nuclear Medicine, Diagnostic Image Analysis Group, Radboudumc, Nijmegen, The Netherlands
| | - Cornelia M Schaefer-Prokop
- Department of Radiology and Nuclear Medicine, Diagnostic Image Analysis Group, Radboudumc, Nijmegen, The Netherlands
- Department of Radiology, Meander Medisch Centrum, Amersfoort, The Netherlands
| | - Ernst T Scholten
- Department of Radiology and Nuclear Medicine, Diagnostic Image Analysis Group, Radboudumc, Nijmegen, The Netherlands
| | - Colin Jacobs
- Department of Radiology and Nuclear Medicine, Diagnostic Image Analysis Group, Radboudumc, Nijmegen, The Netherlands
| | - Mathias Prokop
- Department of Radiology and Nuclear Medicine, Diagnostic Image Analysis Group, Radboudumc, Nijmegen, The Netherlands
| | - Bram van Ginneken
- Department of Radiology and Nuclear Medicine, Diagnostic Image Analysis Group, Radboudumc, Nijmegen, The Netherlands
- Fraunhofer MEVIS, Bremen, Germany
| |
Collapse
|