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ABSTRACT: Background
The 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.Methods
A 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.Results
Patients 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?p?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).Conclusion
The 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.
SUBMITTER: Chen D
PROVIDER: S-EPMC7739212 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
Chen Donglai D Wang Xiaofan X Zhang Fuquan F Han Ruoshuang R Ding Qifeng Q Xu Xuejun X Shu Jian J Ye Fei F Shi Li L Mao Yiming Y Chen Yongbing Y Chen Chang C
Therapeutic advances in medical oncology 20201214
<h4>Background</h4>The 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.<h4>Methods</h4>A 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 ...[more]