Association between tumor heterogeneity and overall survival in patients with non-small cell lung cancer

In this paper, a radiomics approach was proposed to determine whether the tumor heterogeneity of non-small cell lung cancer (NSCLC), which was measured by the texture on computed tomography (CT), could make an independent prediction of overall survival. A primary dataset contained 72 patients (mean survival, 15.9 months) with pathologic diagnosis of NSCLC and a validation dataset contained 67 NSCLC (mean survival, 18.1 months) patients which were used for prognosis trial. The experiment results indicated that the features: «energy of run-length (ERL)» (hazard ratio [HR]: 0.55, 95% confidence interval [CI]: (0.34, 0.89), P = 0.014) and «long-run high gray level emphasis of run-length (LRHGLERL)» (HR: 0.50, 95%CI: (0.32, 0.80), P = 0.005) were significantly associated with overall survival in the primary dataset, and these two texture features also make an consistent performance on the validation cohort. Our study further supported that the quantitative measurement of tumor heterogeneity can be associated with prognosis of NSCLC.