Spread Through Air Spaces Is a Prognostic Factor in Sublobar Resection of Non-Small Cell Lung Cancer
| Autor: | Naoki Yanagawa, Kei Yarimizu, Kazuki Hayasaka, Katsuyuki Suzuki, Makoto Endo, Satoshi Shiono |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Kaplan-Meier Estimate 030204 cardiovascular system & hematology Risk Assessment Disease-Free Survival Cohort Studies 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Carcinoma Humans Medicine Neoplasm Invasiveness Stage (cooking) Risk factor Pneumonectomy Lung cancer Survival analysis Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Analysis of Variance Univariate analysis business.industry Proportional hazards model Biopsy Needle Retrospective cohort study Middle Aged Prognosis medicine.disease Immunohistochemistry Survival Analysis Treatment Outcome 030220 oncology & carcinogenesis Multivariate Analysis Female Surgery Lymph Nodes Radiology Neoplasm Recurrence Local Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 106:354-360 |
| ISSN: | 0003-4975 |
| Popis: | Background Spread through air spaces (STAS) identified in lung cancer is considered to be a risk factor for recurrence after surgery. The purpose of this study is to clarify the prognostic impact of STAS in sublobar resections. Methods We studied 514 patients with clinical stage IA cancers: 329 underwent lobectomies and 185 underwent sublobar resections. We assessed the prognostic impact of STAS in the cases with a sublobar resection for stage IA lung cancer versus the cases with a lobectomy. Results STAS was found in 73 of 329 (22.2%) lobectomy cases and 31 of 185 (16.8%) sublobar resection cases. For overall survival, univariate analysis revealed that STAS was not a prognostic factor in the lobectomy group, but it was a significantly worse prognostic factor for the sublobar resection group in both univariate and multivariate analyses. For the recurrence-free rate, multivariate analysis showed STAS was not a risk factor in the lobectomy group, but it was a significant risk factor for the sublobar resection group in both univariate and multivariate analyses. Patients with STAS and sublobar resection had a significantly higher rate of pulmonary metastases than did patients with STAS and lobectomy (8 of 31 [25.8%] vs 6 of 73 [8.2%]). Conclusions STAS is a prognostic factor of poor outcomes for sublobar resection in patients with lung cancer. The worse prognosis for sublobar resection would be associated with STAS. |
| Databáze: | OpenAIRE |
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