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Prognostic Impact of Tumor Spread Through Air Spaces in Sublobar Resection for 1A Lung Adenocarcinoma Patients

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study aimed to clarify differences in the prognostic impact of tumor spread through air spaces (STAS) in lobectomy versus sublobar resection (SR). The study also investigated the frequency and significance of STAS in residual lung segments.

Methods

This study identified 752 patients with p-stage 1A non-small cell lung cancer (NSCLC) from 2010 to 2012. Recurrence-free survival (RFS) and overall survival (OS) were compared. For proactive simulation of SR, 100 consecutive lobectomy specimens of p-stage 1A NSCLC were selected.

Results

The study found STAS in 182 (28.7%) of 634 lobectomy cases and 43 (36.4%) of 118 SR cases. Multivariable analysis showed that STAS was not a prognostic factor in the lobectomy group, but showed a significantly worse prognostic effect for the SR group (RFS, P < 0.001; OS, P < 0.001). In 9 of 100 simulated cases, STAS occurred in residual lung segments. The patients with T1c category disease had a significantly increased risk for the development of STAS in residual lung segments (P = 0.033).

Conclusions

For patients with p-stage 1A lung cancer who have undergone SR, STAS is a prognostic indicator of poor outcomes. The presence of STAS does occasionally exist in the residual lung segments.

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Acknowledgment

This study was supported by the projects from Shanghai Hospital Development Center (SHDC12015116), the Fundamental Research Funds for the Central Universities (22120180607), the National Natural Science Foundation of China (81802256), the Shanghai Lingjun Program (2015057), and the Shanghai Pujiang Program (15PJD034).

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Author notes

  1. Yijiu Ren, Huikang Xie and Chenyang Dai are equally contributed to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China

    Yijiu Ren MD, Chenyang Dai MD, PhD, Yunlang She MD, Hang Su MD, Dong Xie MD, PhD, Hui Zheng MD, PhD, Gening Jiang MD & Chang Chen MD, PhD

  2. Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China

    Huikang Xie MD, Liping Zhang MD & Chunyan Wu MD

Authors
  1. Yijiu Ren MD
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  2. Huikang Xie MD
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  4. Yunlang She MD
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  5. Hang Su MD
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  6. Dong Xie MD, PhD
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  9. Gening Jiang MD
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  11. Chang Chen MD, PhD
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Correspondence to Chang Chen MD, PhD.

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Ren, Y., Xie, H., Dai, C. et al. Prognostic Impact of Tumor Spread Through Air Spaces in Sublobar Resection for 1A Lung Adenocarcinoma Patients. Ann Surg Oncol 26, 1901–1908 (2019). https://doi.org/10.1245/s10434-019-07296-w

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  • DOI: https://doi.org/10.1245/s10434-019-07296-w

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