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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1524212
This article is part of the Research Topic Innovations in Biomarker-Based Lung Cancer Screening View all 3 articles
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Objective: To enhance the prognostic assessment and management of lung cancer with cystic airspaces (LCCA) by integrating temporal clinical and phenotypic dimensions of tumor growth. Patients and Methods: A retrospective analysis was conducted on LCCA patients treated at two hospitals. Clinical and imaging characteristics were analyzed using the independent samples t-test, Mann-Whitney U test, and χ 2 test. Features with significant differences were further analyzed using multivariate Cox regression to identify independent prognostic factors. Radiomic features were extracted from CT images, and volume doubling time (VDT) was calculated from two follow-up scans. Separate predictive models were constructed based on radiomic features and VDT. A fusion model integrating radiomic features, VDT, and independent clinical prognostic factors was developed. Model performance was evaluated using receiver operating characteristic curve and the area under the curve, with DeLong's test used for comparison. Results: A total of 193 patients were included, with an average survival time of 48.5 months. Significant differences were found between survivors and non-survivors in age, smoking status, chronic obstructive pulmonary disease, and tumor volume (P < 0.05). Multivariate Cox analysis identified smoking and chronic obstructive pulmonary disease as independent risk factors (P = 0.028 and P = 0.013). The VDT for survivors was 421 (298 582.5) days compared to 334.5±106.1 days for non-survivors (Z = -3.330, P = 0.001). In the validation set, the area under the curve for the VDT model was 0.805, for the radiomic model 0.717, and for the fusion model 0.895, demonstrating the highest predictive performance (P < 0.05). Conclusion: Integrating VDT, radiomics, and clinical imaging features into a fusion model improves the accuracy of predicting the five-year survival rate for LCCA patients, enhancing personalized and precise cancer treatment.
Keywords: Lung cancer with cystic airspaces, Survival, Volume doubling time, Radiomics, predictive model
Received: 07 Nov 2024; Accepted: 24 Mar 2025.
Copyright: © 2025 Yin, wang, fu, xing, liu, li and gan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
jing wang, Internet Healthcare, Shandong Provincial Third Hospital, Jinan, Shandong Province, China
jie gan, Medical Imaging, Shandong Provincial Third Hospital, Jinan, Shandong Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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