Impact of Spread Through Air Spaces (STAS) on Recurrence and Surgical Trends in Stage I Non-Small Cell Lung Cancer: A Real-World Cohort Study.

Cheng-Hao Chuang, Yu-Wei Liu, Wei-An Lai, Yi-Wen Shen, Shih-Yu Kao, Yu-Ching Wei, Chu-Chun Chien, Hui-Yang Hung, Jui-Ying Lee, Min-Fang Chao, Jen-Yu Hung, Inn-Wen Chong, Chih-Jen Yang
{"title":"Impact of Spread Through Air Spaces (STAS) on Recurrence and Surgical Trends in Stage I Non-Small Cell Lung Cancer: A Real-World Cohort Study.","authors":"Cheng-Hao Chuang, Yu-Wei Liu, Wei-An Lai, Yi-Wen Shen, Shih-Yu Kao, Yu-Ching Wei, Chu-Chun Chien, Hui-Yang Hung, Jui-Ying Lee, Min-Fang Chao, Jen-Yu Hung, Inn-Wen Chong, Chih-Jen Yang","doi":"10.1002/kjm2.70061","DOIUrl":null,"url":null,"abstract":"<p><p>Non-small cell lung cancer (NSCLC) is the most common form of lung cancer, which remains a leading cause of cancer mortality worldwide. Early detection, particularly at Stage I, is critical for improving survival outcomes. Low-dose computed tomography (LDCT) has increased the detection of small asymptomatic tumors, resulting in an earlier diagnosis and facilitating less invasive surgical approaches such as segmentectomy and wedge resection, which preserve lung function while offering survival outcomes comparable to lobectomy. However, the risk factors for recurrence in Stage I NSCLC remain poorly understood. This retrospective study analyzed 1077 Stage I NSCLC patients treated at Kaohsiung Medical University Hospital from 2010 to 2022. Data including AJCC 7th and 8th editions staging, surgical interventions, and pathological features were analyzed. The proportion of Stage I cases increased significantly from 9.3% in 2010 to 33.8% in 2017, with Stage IA cases increasing from 12.1% in 2018 to 38.2% in 2022. Concurrently, the lobectomy rate decreased from 75% in 2010 to 43.6% in 2022, with more sublobar resections performed. Kaplan-Meier analysis found no significant differences in recurrence-free survival between lobectomy and sublobar resection with regional lymph node dissection. Cox regression identified spread through air spaces (STAS) as an independent risk factor for recurrence (hazard ratio 2.87, p = 0.006), along with male sex, larger tumor size, and visceral pleural invasion. These findings highlight the role of LDCT in early detection and the importance of tailored treatment strategies, particularly addressing STAS, to optimize recurrence-free survival and improve outcomes of patients with Stage I NSCLC.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70061"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Kaohsiung journal of medical sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/kjm2.70061","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer, which remains a leading cause of cancer mortality worldwide. Early detection, particularly at Stage I, is critical for improving survival outcomes. Low-dose computed tomography (LDCT) has increased the detection of small asymptomatic tumors, resulting in an earlier diagnosis and facilitating less invasive surgical approaches such as segmentectomy and wedge resection, which preserve lung function while offering survival outcomes comparable to lobectomy. However, the risk factors for recurrence in Stage I NSCLC remain poorly understood. This retrospective study analyzed 1077 Stage I NSCLC patients treated at Kaohsiung Medical University Hospital from 2010 to 2022. Data including AJCC 7th and 8th editions staging, surgical interventions, and pathological features were analyzed. The proportion of Stage I cases increased significantly from 9.3% in 2010 to 33.8% in 2017, with Stage IA cases increasing from 12.1% in 2018 to 38.2% in 2022. Concurrently, the lobectomy rate decreased from 75% in 2010 to 43.6% in 2022, with more sublobar resections performed. Kaplan-Meier analysis found no significant differences in recurrence-free survival between lobectomy and sublobar resection with regional lymph node dissection. Cox regression identified spread through air spaces (STAS) as an independent risk factor for recurrence (hazard ratio 2.87, p = 0.006), along with male sex, larger tumor size, and visceral pleural invasion. These findings highlight the role of LDCT in early detection and the importance of tailored treatment strategies, particularly addressing STAS, to optimize recurrence-free survival and improve outcomes of patients with Stage I NSCLC.

气道扩散(STAS)对I期非小细胞肺癌复发和手术趋势的影响:一项真实世界队列研究
非小细胞肺癌(NSCLC)是最常见的肺癌形式,它仍然是世界范围内癌症死亡的主要原因。早期发现,特别是在第一阶段,对改善生存结果至关重要。低剂量计算机断层扫描(LDCT)增加了对小的无症状肿瘤的检测,导致早期诊断和促进微创手术方法,如节段切除术和楔形切除术,在保留肺功能的同时提供与肺叶切除术相当的生存结果。然而,I期NSCLC复发的危险因素仍然知之甚少。本回顾性研究分析2010年至2022年在高雄医科大学附属医院治疗的1077例I期非小细胞肺癌患者。数据包括AJCC第7版和第8版分期、手术干预和病理特征分析。I期病例占比从2010年的9.3%显著上升到2017年的33.8%,IA期病例从2018年的12.1%上升到2022年的38.2%。同时,肺叶切除术率从2010年的75%下降到2022年的43.6%,进行了更多的叶下切除术。Kaplan-Meier分析发现,肺叶切除术与叶下切除术合并区域淋巴结清扫在无复发生存率上无显著差异。Cox回归发现,通过空气间隙扩散(STAS)是复发的独立危险因素(风险比2.87,p = 0.006),此外还有男性、较大的肿瘤大小和内脏胸膜浸润。这些发现强调了LDCT在早期发现中的作用以及定制治疗策略的重要性,特别是针对STAS,以优化I期NSCLC患者的无复发生存和改善预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信