Dataset Information

Significance of spread through air spaces in early-stage lung adenocarcinomas undergoing limited resection.

ABSTRACT:

Background

In early-stage lung adenocarcinomas, spread through air spaces (STAS) are reported to be a prognostic factor in patients who have undergone sublobar resection, but not lobectomy. In contrast, reports have also shown that STAS is significantly associated with poor survival outcomes after lobectomy, but not after limited resection. Thus, the prognostic impact of STAS differs according to published reports.

Methods

A total of 82 patients with early-stage adenocarcinomas who underwent limited resection and whose STAS status could be examined were enrolled in this retrospective study. We evaluated the association between STAS and clinicopathological characteristics and postoperative survival.

Results

Among 82 patients, 31 (37.8%) were positive for STAS, while 51 (62.2%) were negative. STAS was significantly associated with advanced tumor stage (P < 0.01), lower histological differentiation (P = 0.01), and the presence of pleural invasion (P = 0.01). Patients with STAS had significantly shorter recurrence-free survival (RFS) and overall survival (OS) than those without STAS (P < 0.01 and P = 0.02, respectively). According to multivariate analysis, positivity for STAS was an independent prognostic parameter for RFS (P < 0.01), but not OS (P = 0.45). Three patients who developed surgical margin recurrence and one patient who developed distant recurrence were all positive for STAS.

Conclusions

STAS was predictive of poor postoperative survival in patients with early-stage adenocarcinomas treated with limited resection and was associated with surgical margin recurrence.

SUBMITTER: Toyokawa G

PROVIDER: S-EPMC6166074 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Significance of spread through air spaces in early-stage lung adenocarcinomas undergoing limited resection.

Toyokawa Gouji G Yamada Yuichi Y Tagawa Tetsuzo T Oda Yoshinao Y

Thoracic cancer 20180806 10

<h4>Background</h4>In early-stage lung adenocarcinomas, spread through air spaces (STAS) are reported to be a prognostic factor in patients who have undergone sublobar resection, but not lobectomy. In contrast, reports have also shown that STAS is significantly associated with poor survival outcomes after lobectomy, but not after limited resection. Thus, the prognostic impact of STAS differs according to published reports.<h4>Methods</h4>A total of 82 patients with early-stage adenocarcinomas wh ...[more]

PMID: 30079987

Similar Datasets

Project description:Background Spread through air spaces (STAS), as a new pattern of invasion, was officially proposed by the World Health Organization (WHO) in 2015, and its importance was reiterated in 2021. Since it was proposed, numerous studies have confirmed that STAS is associated with poor prognosis, but there are relatively few studies related to the prognosis of postoperative patients with lung squamous cell carcinoma. By synthesizing different predictive variables, nomogram can obtain the individual digital probability of clinical events succinctly and intuitively, which can meet our needs for personalized medicine. In this study, our goal is to explore the prognostic value of STAS in lung squamous cell carcinoma and establish a prognostic prediction model. Methods Under six inclusion criteria, 540 postoperative patients were enrolled in the study. STAS was re-evaluated by pathologists at Ningbo Clinicopathological Diagnosis Center. Progression-free survival (PFS) referred to the time from randomization to the first occurrence of disease progression or death of any cause. Recurrences were confirmed by clinical, radiological or pathological assessment. The survival information was collected by telephone and outpatient follow-up. A total of 540 patients were randomly divided into groups in a 6:4 ratio for survival analysis to determine the correlation between STAS and prognosis. Cox regression was used for univariate and multivariate analysis, so as to establish a predictive model. The assessment of the nomogram was carried out by receiver operating characteristic (ROC) curve analysis, calibration curve analysis and decision curve analysis (DCA). Results The overall 5-year survival rate was 70.35% in STAS-negative patients and 42.35% in STAS-positive patients. In all cohorts, STAS-negative patients had longer 5-year PFS than STAS-positive patients (P<0.001). Multivariate analysis showed that stage [stage II P=0.008, hazard ratio (HR) =1.792; stage III P<0.001, HR =3.148], tumor differentiation (well-differentiation P=0.021, HR =0.436), and STAS (P=0.026, HR =1.470) were independent predictors of PFS. The area under the curve (AUC) of model 5 in discovery cohort is 0.720, while the AUC of model 5 in validation cohort is 0.693. Conclusions The nomogram combined with STAS can provide a personalized visual survival probability prediction map for postoperative patients with lung squamous cell carcinoma, so as to aid in the pursuit of personalized medicine to a certain extent.

Project description:BackgroundThe benefit of adjuvant chemotherapy (ACT) remains unknown for patients with stage I lung adenocarcinoma (ADC) with spread through air spaces (STAS). This study investigated the effect of adjuvant chemotherapy in stage I ADC/STAS-positive patients.MethodsA total of 3346 patients with stage I ADC from five institutions in China were identified from 2009 to 2013, of whom 1082 were diagnosed with STAS (32.3%). By using the Kaplan-Meier method and Cox proportional hazard regression model, we explored the impact of STAS on prognosis, and determined if the use of adjuvant chemotherapy was associated with improved outcomes in patients with stage I ADC/STAS-positive. A validation cohort was also included in this study.ResultsPatients with stage I ADC/STAS-positive in the primary cohort had unfavorable overall survival (OS) and disease-free survival (DFS). A multivariate Cox regression model confirmed the survival disadvantages of STAS in patients with stage I ADC [OS: hazards ratio (HR) = 1.877, 95% confidence interval (CI): 1.579-2.231; p < 0.001; DFS: HR = 1.895, 95% CI: 1.614-2.225; p < 0.001]. Lobectomy was associated with better OS and DFS than sublobar resection (SR) in both stage IA and IB ADC/STAS-positive. Similar results were observed in the validation cohort. For patients with stage IB ADC/STAS-positive, ACT was revealed as an independent factor for favorable survival (OS: HR = 0.604, 95% CI: 0.397-0.919; p = 0.018; DFS: HR = 0.565, 95% CI: 0.372-0.858; p = 0.007). However, among patients with stage IA ADC/STAS-positive, ACT was associated with improved outcomes only for those undergoing SR (OS: HR = 0.787, 95% CI: 0.359-0.949; p = 0.034; DFS: HR = 0.703, 95% CI: 0.330-0.904; p = 0.029).ConclusionThe presence of STAS was correlated with poor prognosis in patients with stage I ADC. Our study suggested that ACT might be considered for patients with stage IB ADC/STAS-positive and those with stage IA ADC/STAS-positive who underwent SR.

Dataset Information

Significance of spread through air spaces in early-stage lung adenocarcinomas undergoing limited resection.

Background

Methods

Results

Conclusions

Publications

Significance of spread through air spaces in early-stage lung adenocarcinomas undergoing limited resection.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets