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Spread Through Air Spaces (STAS) in Surgically Resected Lung Adenocarcinoma Prognosis

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Abstract

To investigate the association between tumor spread through air spaces (STAS) and prognosis in surgically resected lung adenocarcinoma in our hospital, the clinicopathological data of 201 patients accepting lung adenocarcinoma surgery from January 2019 to December 2019 were retrospectively reviewed in our hospital. The correlation between clinicopathological features especially the status of STAS and patients’ overall survival and disease-free survival was explored. In addition, subgroup analysis was used to explore the association between STAS and prognosis. A total of 41 (20.4%) patients had positive STAS in hematoxylin and eosin (HE) staining sections. The median follow-up time was 41.03 months, and 16 patients died at the end of the follow-up. On multivariate analysis, Ki67 (HR, 1.019; 95% CI, 1.001–1.037) and STAS (HR, 2.396; 95% CI, 1.054–5.446) were found to be associated with disease-free survival (DFS). However, only pleural invasion (HR, 3.845; 95% CI, 1.196–12.363) was considered to be the independent factor for prognosis in our group. In the STAS-positive group, overall survival (OS) and DFS were significantly lower in patients undergoing sublobar resection than in the lobectomy group. In stage I-II patients, OS and DFS were significantly lower in the STAS-positive group than in the STAS-negative group. In conclusion, STAS is an independent risk factor of poor DFS in resected lung adenocarcinoma patients.

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Data Availability

The data used to support the findings of this study are available from the corresponding author upon request.

Abbreviations

STAS:

Tumor spread through air spaces

HE:

Hematoxylin and eosin

OS:

Overall survival

DFS:

Disease-free survival

GGO:

Ground-glass opacities

CEA:

Carcinoembryonic

pTNM:

Tumor-node-metastasis

CTR:

Consolidation tumor ratio

STAS:

Spread through air spaces

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Acknowledgements

The authors gratefully thank all the patients for providing data.

Funding

This study was supported by the Digital Technologies for the Postoperative Remote Care and Rehabilitation of Thoracic and Cardiac Surgery Patients (No: 2019YFE0105600), Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai Municipal Key Clinical Specialty (shslczdzk02801), and Diagnosis and Treatment of Lung cancer (H1382).

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Author notes

  1. Jing Wang and Yuanshan Yao contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, Shanghai Key Laboratory of Clinical Geriatric Medicine, HuaDong Hospital Affiliated to Fudan University, Shanghai, 200041, China

    Jing Wang, Yuanshan Yao, Dongfang Tang & Wen Gao

Authors
  1. Jing Wang
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  2. Yuanshan Yao
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  3. Dongfang Tang
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  4. Wen Gao
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Contributions

Data acquisition: JW. Drafting of the manuscript: YY. Review of the manuscript: WG and DT. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Wen Gao.

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Ethics Approval and Consent to Participate

The study was approved by the ethics committee of Huadong Hospital, and no informed consent was obtained from patients due to the retrospective nature of our study. All experiments were performed in accordance with relevant guidelines and regulations (Declaration of Helsinki).

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Not applicable.

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The authors declare no competing interests.

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Wang, J., Yao, Y., Tang, D. et al. Spread Through Air Spaces (STAS) in Surgically Resected Lung Adenocarcinoma Prognosis. Indian J Surg 85 (Suppl 2), 483–490 (2023). https://doi.org/10.1007/s12262-023-03863-4

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  • DOI: https://doi.org/10.1007/s12262-023-03863-4

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