Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands; Institute for Diagnostic Accuracy, Groningen, the Netherlands.
Institute for Diagnostic Accuracy, Groningen, the Netherlands.
Eur J Cancer. 2024 Nov;212:114339. doi: 10.1016/j.ejca.2024.114339. Epub 2024 Sep 26.
Lung cancer growth rate influences screening strategies and treatment decisions. This review aims to provide an overview of primary lung cancer growth rate, quantified by volume doubling time (VDT) through computed tomography (CT) measurement.
Using PRISMA-DTA guideline, PubMed, EMBASE, and Web of Science were searched until March 2024 for studies reporting CT-measured VDT of pathologically confirmed primary lung cancer before intervention. Summary data were extracted from published reports by two independent researchers. Primary outcomes were pooled mean VDT of lung cancer by nodule type and histology, distribution of indolent lung cancer (defined as VDT>400 days or negative), and correlated factors.
Thirty-three studies were eligible, comprising 3959 patients with primary lung cancer (mean age range:57.6-77.0 years; 60.0 % men). The pooled mean VDT for solid, part-solid, and nonsolid lung cancer were 207, 536, and 669 days, respectively (p < 0.001). When stratified by histology within solid lung cancer, the pooled mean VDT of adenocarcinoma, squamous cell carcinoma, small cell lung cancer, and others were 223, 140, 73, and 178 days, respectively (p < 0.001). Indolent lung cancer was observed in 34.9 % of lung cancer, predominantly in adenocarcinoma (68.9 %). Adenocarcinoma was associated with slower growth, whereas factors such as tumor size, solidity, TNM staging, and smoking history were positively associated with growth rates.
Pooled mean VDT of solid lung cancer was approximately 207 days, demonstrating significant variability in histology yet remaining under the 400-day referral threshold. Key predictors of growth rate include histology, size, solidity, and smoking history, essential for tailoring early intervention strategies.
CRD42023408069.
肺癌的生长速度影响着筛查策略和治疗决策。本综述旨在提供通过计算机断层扫描（CT）测量体积倍增时间（VDT）定量评估原发性肺癌生长速度的概述。
根据 PRISMA-DTA 指南，检索 PubMed、EMBASE 和 Web of Science 以获取截至 2024 年 3 月报告在干预前通过 CT 测量经病理证实的原发性肺癌的 VDT 的研究。两名独立研究人员从已发表的报告中提取汇总数据。主要结局为按结节类型和组织学划分的肺癌的平均 VDT、惰性肺癌（定义为 VDT>400 天或阴性）的分布以及相关因素。
共有 33 项研究符合纳入标准，共纳入 3959 例原发性肺癌患者（平均年龄范围：57.6-77.0 岁；60.0%为男性）。实性、部分实性和非实性肺癌的平均 VDT 分别为 207、536 和 669 天（p<0.001）。在实性肺癌中按组织学分层，腺癌、鳞状细胞癌、小细胞肺癌和其他类型肺癌的平均 VDT 分别为 223、140、73 和 178 天（p<0.001）。观察到 34.9%的肺癌为惰性肺癌，主要为腺癌（68.9%）。腺癌与生长速度较慢相关，而肿瘤大小、实性、TNM 分期和吸烟史等因素与生长速度呈正相关。
实性肺癌的平均 VDT 约为 207 天，表明组织学存在显著差异，但仍低于 400 天的转诊阈值。生长速度的主要预测因素包括组织学、大小、实性和吸烟史，这对于制定早期干预策略至关重要。
CRD42023408069。
