TY - JOUR
T1 - Significance of Spread Through Air Spaces in Resected Lung Adenocarcinomas With Lymph Node Metastasis
AU - Toyokawa, Gouji
AU - Yamada, Yuichi
AU - Tagawa, Tetsuzo
AU - Kinoshita, Fumihiko
AU - Kozuma, Yuka
AU - Matsubara, Taichi
AU - Haratake, Naoki
AU - Takamori, Shinkichi
AU - Akamine, Takaki
AU - Hirai, Fumihiko
AU - Oda, Yoshinao
AU - Maehara, Yoshihiko
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/9
Y1 - 2018/9
N2 - To clarify the prognostic impact of spread through air spaces (STAS) on survival in completely resected adenocarcinomas with lymph node metastasis, we observed STAS in 45 (73.0%) of 63 patients. Those with STAS had a significantly shorter recurrence-free survival (RFS) than those without STAS (P =.04). Positivity for STAS was an independent prognostic parameter for RFS. Background: Spread through air spaces (STAS) is a recently recognized invasive pattern of lung cancer defined by the World Health Organization as micropapillary clusters, solid nests, or single cells spreading within air spaces beyond the edge of the main tumor. Although STAS has been shown to be a significant prognosticator for the postoperative survival in early-stage lung cancer treated with limited resection, its prognostic impact on the survival in completely resected adenocarcinomas with lymph node metastasis remains unclear. Patients and Methods: STAS was assessed in a total of 63 adenocarcinomas with lymph node metastasis in patients who underwent complete resection. STAS was defined as tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. We evaluated the association between STAS and the clinicopathologic characteristics and the postoperative survival. Results: Among 63 patients, 31 (49.2%) and 32 (50.8%) had disease that was pathologically positive for N1 and N2, respectively. STAS was observed in 45 patients (73.0%) and was not significantly associated with any clinicopathologic characteristics. Patients with the STAS had significantly shorter recurrence-free survival (RFS) but not overall survival than those without STAS (P =.04 and P =.35, respectively). The 5-year RFS in patients with and without STAS was 25.1% and 56.7%, respectively. According to a multivariate analysis, positivity for STAS remained an independent prognostic parameter for RFS (hazard ratio = 3.09; 95% confidence interval, 1.47-7.16; P <.01). Conclusion: STAS was predictive of a poor RFS in completely resected adenocarcinomas with lymph node metastasis.
AB - To clarify the prognostic impact of spread through air spaces (STAS) on survival in completely resected adenocarcinomas with lymph node metastasis, we observed STAS in 45 (73.0%) of 63 patients. Those with STAS had a significantly shorter recurrence-free survival (RFS) than those without STAS (P =.04). Positivity for STAS was an independent prognostic parameter for RFS. Background: Spread through air spaces (STAS) is a recently recognized invasive pattern of lung cancer defined by the World Health Organization as micropapillary clusters, solid nests, or single cells spreading within air spaces beyond the edge of the main tumor. Although STAS has been shown to be a significant prognosticator for the postoperative survival in early-stage lung cancer treated with limited resection, its prognostic impact on the survival in completely resected adenocarcinomas with lymph node metastasis remains unclear. Patients and Methods: STAS was assessed in a total of 63 adenocarcinomas with lymph node metastasis in patients who underwent complete resection. STAS was defined as tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. We evaluated the association between STAS and the clinicopathologic characteristics and the postoperative survival. Results: Among 63 patients, 31 (49.2%) and 32 (50.8%) had disease that was pathologically positive for N1 and N2, respectively. STAS was observed in 45 patients (73.0%) and was not significantly associated with any clinicopathologic characteristics. Patients with the STAS had significantly shorter recurrence-free survival (RFS) but not overall survival than those without STAS (P =.04 and P =.35, respectively). The 5-year RFS in patients with and without STAS was 25.1% and 56.7%, respectively. According to a multivariate analysis, positivity for STAS remained an independent prognostic parameter for RFS (hazard ratio = 3.09; 95% confidence interval, 1.47-7.16; P <.01). Conclusion: STAS was predictive of a poor RFS in completely resected adenocarcinomas with lymph node metastasis.
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U2 - 10.1016/j.cllc.2018.04.002
DO - 10.1016/j.cllc.2018.04.002
M3 - Article
C2 - 29735272
AN - SCOPUS:85046712747
SN - 1525-7304
VL - 19
SP - 395-400.e1
JO - Clinical Lung Cancer
JF - Clinical Lung Cancer
IS - 5
ER -
