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Prognostic Variability in Non-Small Cell Lung Cancer with Pathologic Separate Nodules in the Same Lobe at CT.

Sohee Park1, Jooae Choe1, In Ha Kim1

  • 1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, Korea, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Korea.

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|July 22, 2025
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Summary

For non-small cell lung cancer (NSCLC) with separate nodules (SNs), subsolid nodules indicate better survival. The number of SNs impacts recurrence-free survival, while solid nodule location affects overall survival.

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Area of Science:

  • Thoracic Oncology
  • Radiology
  • Surgical Pathology

Background:

  • Stage T3 non-small cell lung cancer (NSCLC) with separate nodules (SNs) may have variable outcomes.
  • Nodule characteristics are crucial for understanding prognosis in NSCLC with SNs.

Purpose of the Study:

  • To identify prognostic factors based on imaging features of pathologically confirmed SNs within the same lobe in NSCLC patients.
  • To correlate radiologic features of SNs with recurrence-free survival (RFS) and overall survival (OS).

Main Methods:

  • Retrospective study of 1107 patients with pT2b-pT3 NSCLC undergoing lobectomy or pneumonectomy (2010-2021).
  • Radiologic features of SNs were analyzed.
  • Cox proportional hazards regression used to evaluate RFS and OS.

Main Results:

  • Subsolid SNs were an independent negative prognostic factor for RFS and OS (P < .001).
  • The number of SNs was an independent positive prognostic factor for RFS (P = .009).
  • In solid SNs, nonregional location was the only prognostic factor for shorter OS (P = .04). Subsolid SNs showed better survival than solid SNs or pT3-other descriptor tumors.

Conclusions:

  • Ground-glass opacity in SNs is associated with outcome in surgically resected NSCLC.
  • Subsolid SNs are associated with higher survival rates compared to pT3-other descriptor tumors.