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Clinicopathologic Features and Survival Outcomes of Primary Lung Mucinous Adenocarcinoma Based on Different Radiologic Subtypes

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

Abstract

Background

Primary lung mucinous adenocarcinomas (LMAs) could be subclassified as the pure-solid, part-solid, and pneumonic types according to the findings of high-resolution computed tomography. This study aimed to expound on the clinicopathologic, radiologic, and prognostic characteristics of LMAs based on radiologic classification within a large set of patients.

Methods

From November 2009 to December 2016, this study enrolled 294 resected LMAs, which were divided into the pure-solid (n = 169), part-solid (n = 87), and pneumonic (n = 38) types. The clinicopathologic and radiologic characteristics of the tumors were evaluated, and patient prognosis was determined through follow-up evaluation. Survival outcomes were calculated by Kaplan-Meier curves and compared using log-rank tests. The prognostic impact of clinicopathologic variables, including radiologic presentations, were evaluated by establishing a Cox proportional hazards model.

Results

The LMAs were infrequently associated with lymph node metastasis (5.4 %), lymphatic/vascular invasion (4.4 %), or visceral pleural invasion (5.1 %). During the median 71-month follow-up period, recurrence was observed in 62 patients and death in 44 patients. The patients with pneumonic-type LMAs had a poorer prognosis (5-year recurrence-free survival [RFS], 23.7 %; 5-year overall survival [OS], 44.7 %) than those with the pure-solid type (RFS, 83.2 %; OS, 100 %) or part-solid type (RFS, 93.7 %; OS, 100 %). Besides, lymph node metastasis, emphysema, and clinical T stage were independent predictors of RFS and OS.

Conclusion

Solitary-type LMA patients had excellent prognoses, whereas the survival outcomes for pneumonic-type LMA patients were dismal. Furthermore, pneumonic-type LMA patients were prone to intrapulmonary metastasis by means of aerogenous dissemination rather than distant metastasis.

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Acknowledgment

The authors gratefully acknowledge the help of Mr. Huikang Xie (Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine), who kindly evaluated the pathologic retrospective data.

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Author notes

  1. Wei Li and Yingying Yang contributed equally to this study.

Authors and Affiliations

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

    Wei Li MD & Jingyun Shi MD, PhD

  2. Clinical Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China

    Yingying Yang MD

  3. Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China

    Menghang Yang MD

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

    Nan Song MD & Ziwei Wan MD

  5. Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China

    Qing Lu MD

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  1. Wei Li MD
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Correspondence to Qing Lu MD or Jingyun Shi MD, PhD.

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Li, W., Yang, Y., Yang, M. et al. Clinicopathologic Features and Survival Outcomes of Primary Lung Mucinous Adenocarcinoma Based on Different Radiologic Subtypes. Ann Surg Oncol 31, 167–177 (2024). https://doi.org/10.1245/s10434-023-14193-w

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  • DOI: https://doi.org/10.1245/s10434-023-14193-w

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