Tumor Spread through Air Spaces Affects the Recurrence and Overall Survival in Patients with Lung Adenocarcinoma >2 to 3 cm

被引：167

作者：

Dai, Chenyang ^{[1
]}

Xie, Huikang ^{[2
]}

Su, Hang ^{[1
]}

She, Yunlang ^{[1
]}

Zhu, Erjia ^{[1
]}

Fan, Ziwen ^{[1
]}

Zhou, Fangyu ^{[1
]}

Ren, Yijiu ^{[1
]}

Xie, Dong ^{[1
]}

Zheng, Hui ^{[1
]}

Kadeer, Xiermaimaiti ^{[1
]}

Chen, Donglai ^{[1
]}

Zhang, Liping ^{[2
]}

Jiang, Gening ^{[1
]}

Wu, Chunyan ^{[2
]}

Chen, Chang ^{[1
]}

机构：

[1] Tongji Univ, Sch Med, Shanghai Pulm Hosp, Dept Thorac Surg, Shanghai 200443, Peoples R China

[2] Tongji Univ, Sch Med, Shanghai Pulm Hosp, Dept Pathol, Shanghai, Peoples R China

来源：

JOURNAL OF THORACIC ONCOLOGY | 2017年 / 12卷 / 07期

关键词：

Spread through air spaces; Adenocarcinoma; Invasion; Recurrence; Prognosis; PULMONARY ADENOCARCINOMA; ADJUVANT CHEMOTHERAPY; CANCER; CLASSIFICATION; IMPACT; PROGNOSIS; RESECTION; DEATH;

D O I：

10.1016/j.jtho.2017.03.020

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: Tumor spread through air spaces (STAS) is a novel invasive pattern in lung adenocarcinoma (ADC). The effects of the combination of STAS and tumor size on survival have not been well studied. Methods: A total of 383 patients with ADC 3 cm or smaller (stage IA) and 161 patients with stage IB ADC were identified from 2009 to 2010. Recurrence-free survival (RFS) and overall survival (OS) were compared between patients as stratified by STAS and tumor size. A validation cohort was included in this study. Results: STAS was observed in 116 ADCs 3 cm or smaller (30.3%). In cases involving ADCs 3 cm or smaller, patients with STAS had worse RFS (p = 0.006) and OS rates (p < 0.001) than those without STAS. Furthermore, comparable RFS (p = 0.091) and OS (p = 0.443) rates were observed in patients with ADCs 3 cm or smaller with STAS present and those with stage IB ADC. Multivariate analysis revealed STAS to be an independent prognostic factor in ADCs 3 cm or smaller (RFS, p = 0.043; OS, p = 0.009). Among patients with ADCs larger than 2 to 3 cm, STAS still stratified the prognosis. Moreover, the unfavorable prognosis of patients with ADCs larger than 2 to 3 cm with STAS present was similar to that of patients with stage IB ADC. Among patients with ADCs 2 cm or smaller, STAS failed to stratify the prognosis significantly. Similar results were obtained in the validation cohort. Conclusions: These results provide preliminary evidence that STAS could be considered as a factor in a staging system to predict prognosis more precisely, especially in ADCs larger than 2 to 3 cm. (C) 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

引用

页码：1052 / 1060

页数：9

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Tumor Spread through Air Spaces Affects the Recurrence and Overall Survival in Patients with Lung Adenocarcinoma &gt;2 to 3 cm

Tumor Spread through Air Spaces Affects the Recurrence and Overall Survival in Patients with Lung Adenocarcinoma >2 to 3 cm