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A Multi-institutional Analysis of the Combined Effect of Micropapillary Component and Consolidation-to-Tumor Ratio >0.5 on the Prognosis of Pathological, Stage IA3, Lung Adenocarcinoma

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

Abstract

Introduction

The study investigated the synergistic effect of the micropapillary (MIP) component and consolidation-to-tumor ratio (CTR) on the recurrence and survival of patients with pathologic stage IA3 lung adenocarcinoma.

Methods

We enrolled 419 patients confirmed pathological stage IA3 adenocarcinoma from four institutions. Kaplan–Meier analysis was performed to examine the value of the MIP component and CTR on relapse-free survival (RFS) and overall survival (OS). The cumulative recurrence between different stages was analyzed by using cumulative event curves.

Results

RFS (P < 0.0001) and OS (P = 0.008) in the presence of the MIP group were significantly lower than those in the absence of the MIP group, and CTR > 5 only reduced RFS (P = 0.0004), but not OS (P = 0.063), in the patients. In addition, the prognosis of patients with both the MIP component and CTR > 5 was worse than that of those without the MIP component or CTR ≤ 5. Therefore, we established new subtypes of the stage IA3: IA3a, IA3b, and IA3c. RFS and OS for IA3c staging were significantly lower than those for IA3a and IA3b. For IA3c, the cumulative incidence of local recurrence (P < 0.001) and that of distant metastasis (P = 0.004) were significantly higher than those for IA3a and IA3b.

Conclusions

The MIP component combined with CTR > 0.5 can effectively predict the prognosis of patients with pathological stage IA3 lung adenocarcinoma and may offer more detailed recurrence and survival information according to the established subtype stage of IA3.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This study was supported by grants from the Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University (No.0713304); the Natural Science Foundation in Fujian Province (No. 2020J011004); the Fujian provincial health technology project (No. 2020CXA028); the cohort study of the School of Public Health, Fujian Medical University (No. 2021HX003); the Joint Funds for the innovation of science and Technology, Fujian province (No.2020Y9076); and the National Nature Science Foundation of China (No.82273415).

Author information

Author notes

  1. Shao-jun Xu, Jia-hua Tu and Hui Chen contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China

    Shao-jun Xu MD, Rui-qin Chen MD, Chao Chen MD, Cheng-xiong You MD, Zhi-fan Zhang MD, Shao-bin Yu MD & Shu-chen Chen PD

  2. Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China

    Shao-jun Xu MD, Rui-qin Chen MD, Chao Chen MD, Cheng-xiong You MD, Zhi-fan Zhang MD, Shao-bin Yu MD & Shu-chen Chen PD

  3. Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China

    Shao-jun Xu MD, Rui-qin Chen MD, Chao Chen MD, Cheng-xiong You MD, Zhi-fan Zhang MD, Shao-bin Yu MD & Shu-chen Chen PD

  4. Department of Thoracic Surgery, The First Hospital of Putian, Putian, Fujian Province, China

    Jia-hua Tu MD

  5. Department of Thoracic and Cardiac Surgery, Ningde Municipal Hospital of Ningde Normal University, Ningde, China

    Hui Chen MD

  6. Department of Cardiothoracic Surgery, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, China

    Ren-he Yan MD

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  1. Shao-jun Xu MD
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Correspondence to Shu-chen Chen PD.

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Ethical Approval

This study was reviewed and approved by the Institutional Ethics Review Committee of the Fujian Medical University Union Hospital (IRB: No. 2018KY033)

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Xu, Sj., Tu, Jh., Chen, H. et al. A Multi-institutional Analysis of the Combined Effect of Micropapillary Component and Consolidation-to-Tumor Ratio >0.5 on the Prognosis of Pathological, Stage IA3, Lung Adenocarcinoma. Ann Surg Oncol 30, 5843–5853 (2023). https://doi.org/10.1245/s10434-023-13658-2

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