OBJECTIVE: Spread through air spaces (STAS) is a pattern of invasion present in some adenocarcinomas (ADC). The goal of this study was to assess the impact of STAS in patients treated with different types of surgical resections and on the clinical outcome in patients with ADC of different diameters and with different degrees of nodal involvement.METHODS: A total of 109 patients were reviewed. Complete surgical resection with systematic nodal dissection was achieved in all patients. The median follow-up was 65 months (3-90 months).RESULTS: STAS was observed in 70 cases (64.2%); 13 patients (18.5%) had lymph node involvement (N1 and N2). Overall survival and progression-free survival were higher in patients without STAS (P= 0.042; P= 0.027). The presence of STAS in tumours <= 2 cm was a predictor of worse progression-free survival following sublobar resection compared to major resections (P= 0.011). Sublobar resection of NO STAS-positive tumours was associated with worse long-term survival compared to a major resection (P = 0.04). Statistical analyses showed that age >70 years and recurrence were independent variables for survival; smoking pack-years >20, sublobar resection and nodal involvement were independent variables for recurrence; and smoking pack-years >20 were independent variables for a history of cancer and pleural invasion for local recurrence.CONCLUSIONS: STAS seems to play a role in long-term survival, particularly for patients with N0 and tumours smaller than 2 cm. Further studies are necessary to validate this hypothesis.

Prognostic impact of spread through air spaces in lung adenocarcinoma / Mantovani, Sara; Pernazza, Angelina; Bassi, Massimiliano; Amore, Davide; Vannucci, Jacopo; Poggi, Camilla; Diso, Daniele; D'Amati, Giulia; Della Rocca, Carlo; Rendina, Erino Angelo; Venuta, Federico; Anile, Marco. - In: INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY. - ISSN 1569-9285. - 34:6(2022), pp. 1011-1015. [10.1093/icvts/ivab289]

Prognostic impact of spread through air spaces in lung adenocarcinoma

Mantovani, Sara
Primo
Writing – Original Draft Preparation
;
Pernazza, Angelina
Secondo
Conceptualization
;
Bassi, Massimiliano
Formal Analysis
;
Amore, Davide
Data Curation
;
Vannucci, Jacopo
Validation
;
Poggi, Camilla
Investigation
;
Diso, Daniele
Supervision
;
d'Amati, Giulia
Writing – Review & Editing
;
Della Rocca, Carlo
Writing – Review & Editing
;
Rendina, Erino Angelo
Supervision
;
Venuta, Federico
Penultimo
Supervision
;
Anile, Marco
Ultimo
Conceptualization
2022

Abstract

OBJECTIVE: Spread through air spaces (STAS) is a pattern of invasion present in some adenocarcinomas (ADC). The goal of this study was to assess the impact of STAS in patients treated with different types of surgical resections and on the clinical outcome in patients with ADC of different diameters and with different degrees of nodal involvement.METHODS: A total of 109 patients were reviewed. Complete surgical resection with systematic nodal dissection was achieved in all patients. The median follow-up was 65 months (3-90 months).RESULTS: STAS was observed in 70 cases (64.2%); 13 patients (18.5%) had lymph node involvement (N1 and N2). Overall survival and progression-free survival were higher in patients without STAS (P= 0.042; P= 0.027). The presence of STAS in tumours <= 2 cm was a predictor of worse progression-free survival following sublobar resection compared to major resections (P= 0.011). Sublobar resection of NO STAS-positive tumours was associated with worse long-term survival compared to a major resection (P = 0.04). Statistical analyses showed that age >70 years and recurrence were independent variables for survival; smoking pack-years >20, sublobar resection and nodal involvement were independent variables for recurrence; and smoking pack-years >20 were independent variables for a history of cancer and pleural invasion for local recurrence.CONCLUSIONS: STAS seems to play a role in long-term survival, particularly for patients with N0 and tumours smaller than 2 cm. Further studies are necessary to validate this hypothesis.
2022
adenocarcinoma; lymph node involvement; pulmonary resections; STAS; aged; humans; neoplasm invasiveness; neoplasm recurrence, local; neoplasm staging; prognosis; retrospective studies; adenocarcinoma of lung; lung neoplasms
01 Pubblicazione su rivista::01a Articolo in rivista
Prognostic impact of spread through air spaces in lung adenocarcinoma / Mantovani, Sara; Pernazza, Angelina; Bassi, Massimiliano; Amore, Davide; Vannucci, Jacopo; Poggi, Camilla; Diso, Daniele; D'Amati, Giulia; Della Rocca, Carlo; Rendina, Erino Angelo; Venuta, Federico; Anile, Marco. - In: INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY. - ISSN 1569-9285. - 34:6(2022), pp. 1011-1015. [10.1093/icvts/ivab289]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1640899
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