Evidence map›Paper›PMID 41528590›Full record

ArticleGeneral thoracic and cardiovascular surgery2026

Tumor-pleura distance as a prognostic marker in clinical stage IA solid-predominant and pure-solid non-small cell lung cancer: impact on recurrence and survival outcomes by radiological subtype.

Seijiro Sato, Saeko Nakayama, Hiroshi Tanaka, Hirohiko Shinohara

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Article in General thoracic and cardiovascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Seijiro SatoDivision of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan. okura1127@gmail.com.
Saeko NakayamaDivision of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan.
Hiroshi TanakaDivision of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan.
Hirohiko ShinoharaDivision of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan.

Funding

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6 · The paper itself

Abstract

purposeThe intrapulmonary location of a tumor is important for evaluating recurrence risk. This study assessed the prognostic impact of the tumor-pleura distance (TPd) in patients with clinical stage IA solid-predominant or pure-solid non-small cell lung cancer (NSCLC), as well as associations with pleural invasion, recurrence, and tumor subtype defined by the consolidation-to-tumor ratio (CTR).

methodsA total of 358 patients who underwent anatomical lung resection for clinical stage IA NSCLC between 2014 and 2023 were retrospectively analyzed. TPd and CTR were measured on preoperative computed tomography. Receiver-operating characteristic analysis for pleural invasion identified an optimal TPd cutoff of 2.0 mm.

resultsA 2-mm cutoff classified tumors as pleura-adjacent (< 2 mm) or non-pleura-adjacent (≥ 2 mm), with pleural invasion observed in 23.5% of pleura-adjacent and 4.5% of non-pleura-adjacent tumors (P < 0.001). The 5-year recurrence-free survival (RFS) rate was significantly lower in the pleura-adjacent group (68.9% vs. 80.2%, P = 0.021). Multivariate analysis identified pleura-adjacent as an independent predictor of RFS (HR, 1.755; 95% confidence interval (CI) 1.097-2.805; P = 0.019). In the pure-solid subgroup, pleura-adjacent tumors were an independent predictor of RFS (HR, 2.168; 95% CI 1.283-3.663; P = 0.004); no association was found in the solid-predominant subgroup. In the pure-solid subgroup, competing-risk analysis identified pleura-adjacent as an independent risk factor for locoregional recurrence (HR, 2.558; 95% CI 1.250-5.234; P = 0.010).

conclusionTPd < 2 mm is a radiological marker strongly associated with pleural invasion. Its adverse prognostic impact was the most evident in pure-solid tumors, in which pleura-adjacent lesions were linked to poorer RFS and higher locoregional recurrence.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsPleuraPneumonectomyAgedFemaleHumansMaleMiddle AgedMultivariate AnalysisNeoplasm InvasivenessNeoplasm Recurrence, LocalNeoplasm StagingPredictive Value of TestsPrognosisRisk FactorsConsolidation-to-tumor ratioLocoregional recurrenceLung cancerTumor-pleura distanceVisceral pleura

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.