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Predictors of recurrence and survival of pathological T1N0M0 invasive adenocarcinoma following lobectomy

  • Original Article – Cancer Research
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

This retrospective research was designed to investigate the relationship between pT1N0M0 invasive adenocarcinoma (IADC) harboring solid (SOL) and/or micropapillary (MIP) components and its prognosis following lobectomy.

Methods

Clinical data of pT1N0M0 IADC patients were retrospectively collected from Shanghai Chest Hospital. Survival curves were plotted by Kaplan–Meier methods. Multivariable cox regressions were conducted to discover the independent risk factors of recurrence-free survival (RFS) and overall survival (OS), through which nomograms were performed to visualize the risk of recurrences and outcomes in personalized information.

Results

Totally, 1965 patients were enrolled, including 248 harboring SOL/MIP and 1717 not. IADC demonstrated worse 5-year RFS (81.9 vs. 92.2%, p < 0.001) and OS (85.7 vs. 94.4%, p < 0.001) when harboring SOL and/or MIP components. And this status became an independent factor associated with poorer RFS (HR 2.445, 95% CI 1.565–3.821, p < 0.001) and OS (HR 2.139, 95% CI 1.180–3.878, p = 0.012) instead of novel classification of IADC predominant patterns. No difference existed between SOL/MIP predominant and minor patterns. In addition, age > 60, smoking, post-chemotherapy and T1b were all indicating poorer RFS and smoking was also related with worse OS. The c-indexes of nomograms were 0.723 for RFS (95% CI, 0.662–0.784) and 0.703 for OS (95% CI, 0.629–0.777) respectively.

Conclusions

Once the pT1N0M0 IADC harboring SOL/MIP, it strongly indicated the worse clinical recurrence and survival outcome, no matter whether the SOL and/or MIP was predominant. Smoking was correlated with worse prognosis for those patients. Age > 60 and stage T1b also indicated poorer RFS. Whether post-chemotherapy was harmful to pT1N0M0 IADC patients needed further research.

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Abbreviations

NSCLC:

Non-small-cell lung cancer

RFS:

Recurrence-free survival

OS:

Overall survival

IADC:

Invasive adenocarcinoma

LEP:

Lepidic

ACN:

Acinar

PAP:

Papillary

SOL:

Solid

MIP:

Micropapillary

AAH:

Atypical adenomatous hyperplasia

AIS:

Adenocarcinoma in situ

MIA:

Minimally invasive adenocarcinoma

PI:

Pleural invasion

LVI:

Lymphovascular invasion

C-index:

Concordance index

HR:

Hazard ratio

CI:

Confidence interval

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Funding

This work was supported by the National Natural Science Foundation of China (81572253, 81330056, 81401891, 81422029 and 81372525).

Author information

Author notes

  1. Yiyang Wang and Difan Zheng contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China

    Yiyang Wang, Jiajie Zheng, Qingyuan Huang & Heng Zhao

  2. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China

    Difan Zheng & Haiquan Chen

  3. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China

    Baohui Han

  4. Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China

    Jie Zhang

  5. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Haiquan Chen

Authors
  1. Yiyang Wang
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  2. Difan Zheng
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  3. Jiajie Zheng
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  4. Qingyuan Huang
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  5. Baohui Han
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  6. Jie Zhang
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  7. Heng Zhao
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Contributions

HC is the guarantor of the manuscript. YW contributed to conception and study design, acquisition and analysis of data, and writing and revision of the manuscript. DZ contributed to conception and study design, acquisition and analysis of data, and writing and revision of the manuscript. JZ contributed to acquisition of data and writing and revision of the manuscript. QH contributed to acquisition of data and writing and revision of the manuscript. BH contributed to analysis of data and revision of the manuscript. JZ contributed to analysis of data and revision of the manuscript. HZ contributed to analysis of data and revision of the manuscript. HC contributed to conception and study design, analysis of data, and review and revision of the manuscript.

Corresponding author

Correspondence to Haiquan Chen.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study was conducted in line with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards and was approved by the Institutional Review Board of Shanghai Chest Hospital.

Informed consent

Written informed consent was obtained from each patient to allow their biological samples to be genetically analyzed.

Electronic supplementary material

Below is the link to the electronic supplementary material.

S1 Fig. 5-year recurrence-free survival (1A) and overall survival (1B) in patients with pT1N0M0 invasive adenocarcinoma underwent lobectomy

. SOL or MIP predominant, solid and/or micropapillary predominant subtypes. SOL or MIP minor, subtypes containing solid and/or micropapillary but not in predominance. SOL or MIP absent, subtypes not containing any solid and/or micropapillary components. Supplementary material 1 (TIF 1396 KB)

Supplementary material 2 (DOCX 20 KB)

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Wang, Y., Zheng, D., Zheng, J. et al. Predictors of recurrence and survival of pathological T1N0M0 invasive adenocarcinoma following lobectomy. J Cancer Res Clin Oncol 144, 1015–1023 (2018). https://doi.org/10.1007/s00432-018-2622-8

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  • DOI: https://doi.org/10.1007/s00432-018-2622-8

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