Significance of Spread Through Air Spaces in Resected Pathological Stage I Lung Adenocarcinoma

Gouji Toyokawa, Yuichi Yamada, Tetsuzo Tagawa, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Shinkichi Takamori, Takaki Akamine, Yoshinao Oda, Yoshihiko Maehara

研究成果: ジャーナルへの寄稿記事

16 引用 (Scopus)

抄録

Background: “Spread through air spaces” (STAS) is a recently described invasive pattern of lung cancer that spreads within air spaces beyond the edge of the main tumor. In the current study, we investigated the significance of STAS in patients with pathologic stage I adenocarcinoma. Methods: We assessed STAS in a total of 276 patients with resected pathologic stage I adenocarcinoma. STAS was classified as either no STAS, low STAS (1-4 single cells or clusters of STAS), or high STAS (≥5 single cells or clusters of STAS) using a 20x objective and a 10x ocular lens. We evaluated the association between STAS and the clinicopathologic characteristics and postoperative survivals. Results: Among 276 patients, 123 (44.6%), 48 (17.4%), and 105 (38.0%) were classified as having no, low, and high STAS, respectively. The positivity for STAS was significantly associated with larger radiologic tumor diameter (p = 0.008), higher consolidation/tumor ratio (p < 0.001), higher maximum standard uptake value (p < 0.001), pathologically larger tumor size (p = 0.004), pleural invasion (p = 0.027), and histologically invasive type (p < 0.001); whereas STAS was not significantly associated with epidermal growth factor receptor mutations or programmed death ligand-1 expression (p = 0.129 and p = 0.872, respectively). Patients with STAS had significantly shorter recurrence-free and overall survival than patients without STAS (p < 0.001 and p = 0.002, respectively). According to a multivariate analysis, positivity for STAS remained an independent prognostic factor for both recurrence-free survival and overall survival. Conclusions: Spread through air spaces was associated with clinicopathologically invasive features and was predictive of worse survival.

元の言語英語
ページ(範囲)1655-1663
ページ数9
ジャーナルAnnals of Thoracic Surgery
105
発行部数6
DOI
出版物ステータス出版済み - 6 1 2018

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Air
Survival
Adenocarcinoma of lung
Neoplasms
Adenocarcinoma
Recurrence
Crystalline Lens
Epidermal Growth Factor Receptor
Lung Neoplasms
Multivariate Analysis
Ligands

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

これを引用

Significance of Spread Through Air Spaces in Resected Pathological Stage I Lung Adenocarcinoma. / Toyokawa, Gouji; Yamada, Yuichi; Tagawa, Tetsuzo; Kozuma, Yuka; Matsubara, Taichi; Haratake, Naoki; Takamori, Shinkichi; Akamine, Takaki; Oda, Yoshinao; Maehara, Yoshihiko.

:: Annals of Thoracic Surgery, 巻 105, 番号 6, 01.06.2018, p. 1655-1663.

研究成果: ジャーナルへの寄稿記事

Toyokawa, G, Yamada, Y, Tagawa, T, Kozuma, Y, Matsubara, T, Haratake, N, Takamori, S, Akamine, T, Oda, Y & Maehara, Y 2018, 'Significance of Spread Through Air Spaces in Resected Pathological Stage I Lung Adenocarcinoma', Annals of Thoracic Surgery, 巻. 105, 番号 6, pp. 1655-1663. https://doi.org/10.1016/j.athoracsur.2018.01.037
Toyokawa, Gouji ; Yamada, Yuichi ; Tagawa, Tetsuzo ; Kozuma, Yuka ; Matsubara, Taichi ; Haratake, Naoki ; Takamori, Shinkichi ; Akamine, Takaki ; Oda, Yoshinao ; Maehara, Yoshihiko. / Significance of Spread Through Air Spaces in Resected Pathological Stage I Lung Adenocarcinoma. :: Annals of Thoracic Surgery. 2018 ; 巻 105, 番号 6. pp. 1655-1663.
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title = "Significance of Spread Through Air Spaces in Resected Pathological Stage I Lung Adenocarcinoma",
abstract = "Background: “Spread through air spaces” (STAS) is a recently described invasive pattern of lung cancer that spreads within air spaces beyond the edge of the main tumor. In the current study, we investigated the significance of STAS in patients with pathologic stage I adenocarcinoma. Methods: We assessed STAS in a total of 276 patients with resected pathologic stage I adenocarcinoma. STAS was classified as either no STAS, low STAS (1-4 single cells or clusters of STAS), or high STAS (≥5 single cells or clusters of STAS) using a 20x objective and a 10x ocular lens. We evaluated the association between STAS and the clinicopathologic characteristics and postoperative survivals. Results: Among 276 patients, 123 (44.6{\%}), 48 (17.4{\%}), and 105 (38.0{\%}) were classified as having no, low, and high STAS, respectively. The positivity for STAS was significantly associated with larger radiologic tumor diameter (p = 0.008), higher consolidation/tumor ratio (p < 0.001), higher maximum standard uptake value (p < 0.001), pathologically larger tumor size (p = 0.004), pleural invasion (p = 0.027), and histologically invasive type (p < 0.001); whereas STAS was not significantly associated with epidermal growth factor receptor mutations or programmed death ligand-1 expression (p = 0.129 and p = 0.872, respectively). Patients with STAS had significantly shorter recurrence-free and overall survival than patients without STAS (p < 0.001 and p = 0.002, respectively). According to a multivariate analysis, positivity for STAS remained an independent prognostic factor for both recurrence-free survival and overall survival. Conclusions: Spread through air spaces was associated with clinicopathologically invasive features and was predictive of worse survival.",
author = "Gouji Toyokawa and Yuichi Yamada and Tetsuzo Tagawa and Yuka Kozuma and Taichi Matsubara and Naoki Haratake and Shinkichi Takamori and Takaki Akamine and Yoshinao Oda and Yoshihiko Maehara",
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T1 - Significance of Spread Through Air Spaces in Resected Pathological Stage I Lung Adenocarcinoma

AU - Toyokawa, Gouji

AU - Yamada, Yuichi

AU - Tagawa, Tetsuzo

AU - Kozuma, Yuka

AU - Matsubara, Taichi

AU - Haratake, Naoki

AU - Takamori, Shinkichi

AU - Akamine, Takaki

AU - Oda, Yoshinao

AU - Maehara, Yoshihiko

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: “Spread through air spaces” (STAS) is a recently described invasive pattern of lung cancer that spreads within air spaces beyond the edge of the main tumor. In the current study, we investigated the significance of STAS in patients with pathologic stage I adenocarcinoma. Methods: We assessed STAS in a total of 276 patients with resected pathologic stage I adenocarcinoma. STAS was classified as either no STAS, low STAS (1-4 single cells or clusters of STAS), or high STAS (≥5 single cells or clusters of STAS) using a 20x objective and a 10x ocular lens. We evaluated the association between STAS and the clinicopathologic characteristics and postoperative survivals. Results: Among 276 patients, 123 (44.6%), 48 (17.4%), and 105 (38.0%) were classified as having no, low, and high STAS, respectively. The positivity for STAS was significantly associated with larger radiologic tumor diameter (p = 0.008), higher consolidation/tumor ratio (p < 0.001), higher maximum standard uptake value (p < 0.001), pathologically larger tumor size (p = 0.004), pleural invasion (p = 0.027), and histologically invasive type (p < 0.001); whereas STAS was not significantly associated with epidermal growth factor receptor mutations or programmed death ligand-1 expression (p = 0.129 and p = 0.872, respectively). Patients with STAS had significantly shorter recurrence-free and overall survival than patients without STAS (p < 0.001 and p = 0.002, respectively). According to a multivariate analysis, positivity for STAS remained an independent prognostic factor for both recurrence-free survival and overall survival. Conclusions: Spread through air spaces was associated with clinicopathologically invasive features and was predictive of worse survival.

AB - Background: “Spread through air spaces” (STAS) is a recently described invasive pattern of lung cancer that spreads within air spaces beyond the edge of the main tumor. In the current study, we investigated the significance of STAS in patients with pathologic stage I adenocarcinoma. Methods: We assessed STAS in a total of 276 patients with resected pathologic stage I adenocarcinoma. STAS was classified as either no STAS, low STAS (1-4 single cells or clusters of STAS), or high STAS (≥5 single cells or clusters of STAS) using a 20x objective and a 10x ocular lens. We evaluated the association between STAS and the clinicopathologic characteristics and postoperative survivals. Results: Among 276 patients, 123 (44.6%), 48 (17.4%), and 105 (38.0%) were classified as having no, low, and high STAS, respectively. The positivity for STAS was significantly associated with larger radiologic tumor diameter (p = 0.008), higher consolidation/tumor ratio (p < 0.001), higher maximum standard uptake value (p < 0.001), pathologically larger tumor size (p = 0.004), pleural invasion (p = 0.027), and histologically invasive type (p < 0.001); whereas STAS was not significantly associated with epidermal growth factor receptor mutations or programmed death ligand-1 expression (p = 0.129 and p = 0.872, respectively). Patients with STAS had significantly shorter recurrence-free and overall survival than patients without STAS (p < 0.001 and p = 0.002, respectively). According to a multivariate analysis, positivity for STAS remained an independent prognostic factor for both recurrence-free survival and overall survival. Conclusions: Spread through air spaces was associated with clinicopathologically invasive features and was predictive of worse survival.

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U2 - 10.1016/j.athoracsur.2018.01.037

DO - 10.1016/j.athoracsur.2018.01.037

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EP - 1663

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

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