TY - JOUR
T1 - Prognosis of spread through air spaces in invasive mucinous lung adenocarcinoma after curative surgery
AU - Lee, Joonseok
AU - Cho, Sukki
AU - Chung, Jin Haeng
AU - Yoon, Seung Hwan
AU - Shih, Beatrice Chia Hui
AU - Jung, Woohyun
AU - Jeon, Jae Hyun
AU - Kim, Kwhanmien
AU - Jheon, Sanghoon
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/4
Y1 - 2024/4
N2 - Introduction: The purpose of this study is to investigate the prognostic impact of spread through air spaces (STAS) in invasive mucinous adenocarcinoma (IMA). Materials and methods: From 2015 to 2019, patients who underwent complete resection of IMA were extracted from the prospective database. Multivariable Cox-regression analysis and inverse probability of treatment weight (IPTW) - adjusted log-rank test for 5-year recurrence-free survival (RFS) were performed. Results: STAS was observed in 39.1% (53 out of 133). The STAS (+) group shows larger tumor size (2.9 ± 2.4 cm vs 3.8 ± 2.4 cm, p = 0.031) and higher incidence of lympho-vascular invasion (6 [7.5%] vs 18 [34.0%], p < 00.001) compared to the STAS (−) group. The 5-year RFS was 66.1% in the STAS (+) group and 91.8% in the STAS (−) group (p < 00.001), and the incidence of locoregional recurrence was significantly higher in the STAS (+) group than the STAS (−) group (1 [1.2%] vs 12 [22.6%], p < 00.001). Multivariable analysis revealed that STAS was associated with poor prognosis for all-recurrence (hazard ratio 2.81, 95% confidence interval 1.01–7.81, p = 0.048). After IPTW adjustment, 5-year RFS was 66.3% in the STAS (+) group and 92.9% in the STAS (−) group (p = 0.007), and risk for locoregional recurrence was greater in the STAS (+) group than the STAS (−) group (1.1 [0.9%] vs 20.8 [16.6%], p < 00.001). Conclusions: STAS showed negative prognostic impact on all-recurrence, especially due to locoregional recurrence, after curative resection of IMA.
AB - Introduction: The purpose of this study is to investigate the prognostic impact of spread through air spaces (STAS) in invasive mucinous adenocarcinoma (IMA). Materials and methods: From 2015 to 2019, patients who underwent complete resection of IMA were extracted from the prospective database. Multivariable Cox-regression analysis and inverse probability of treatment weight (IPTW) - adjusted log-rank test for 5-year recurrence-free survival (RFS) were performed. Results: STAS was observed in 39.1% (53 out of 133). The STAS (+) group shows larger tumor size (2.9 ± 2.4 cm vs 3.8 ± 2.4 cm, p = 0.031) and higher incidence of lympho-vascular invasion (6 [7.5%] vs 18 [34.0%], p < 00.001) compared to the STAS (−) group. The 5-year RFS was 66.1% in the STAS (+) group and 91.8% in the STAS (−) group (p < 00.001), and the incidence of locoregional recurrence was significantly higher in the STAS (+) group than the STAS (−) group (1 [1.2%] vs 12 [22.6%], p < 00.001). Multivariable analysis revealed that STAS was associated with poor prognosis for all-recurrence (hazard ratio 2.81, 95% confidence interval 1.01–7.81, p = 0.048). After IPTW adjustment, 5-year RFS was 66.3% in the STAS (+) group and 92.9% in the STAS (−) group (p = 0.007), and risk for locoregional recurrence was greater in the STAS (+) group than the STAS (−) group (1.1 [0.9%] vs 20.8 [16.6%], p < 00.001). Conclusions: STAS showed negative prognostic impact on all-recurrence, especially due to locoregional recurrence, after curative resection of IMA.
KW - Adenocarcinoma
KW - Mucinous
KW - Non-small cell lung cancer
KW - Spread through air spaces
KW - Thoracic surgery
UR - http://www.scopus.com/inward/record.url?scp=85186090593&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2024.108053
DO - 10.1016/j.ejso.2024.108053
M3 - Article
C2 - 38412587
AN - SCOPUS:85186090593
SN - 0748-7983
VL - 50
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 4
M1 - 108053
ER -