Prognostic significance of micropapillary pattern and risk factors in patients with resected stage I lung adenocarcinoma and possible benefit of adjuvant therapy: a real-world multicenter study.

IF 3.5 2区医学 Q2 ONCOLOGY

Translational lung cancer research Pub Date : 2025-07-31 Epub Date: 2025-07-28 DOI:10.21037/tlcr-2025-698

Jianjie Li, Yujia Chi, Bo Jia, Qiwen Zheng, Minghan Yuan, Jianjun Zhang, Aishen Zhou, Wei Sun, Yue Yang, Jun Zhao, Tongtong An, Yuyan Wang, Minglei Zhuo, Xue Yang, Hanxiao Chen, Jingjing Wang, Xiaoyu Zhai, Yidi Tai, Yuling He, Lingdong Kong, Xumeng Ji, Yiliang Liu, Nan Wu, Ken Onodera, Paul Van Schil, Mathew Thomas, Fan Yang, Ziping Wang

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引用次数: 0

Abstract

Background: Micropapillary (MP) pattern has been identified as a negative prognostic factor in patients with lung adenocarcinoma, but it has not been recognized as a high-risk factor for patients with stage IB lung adenocarcinoma treated with adjuvant chemotherapy. This multicenter cohort study aimed to evaluate the prognostic value of histological subtypes for stage I lung adenocarcinoma and to determine the relative survival benefit of adjuvant chemotherapy for subgroups based on MP pattern.

Methods: This retrospective study included 412 patients with stage I lung adenocarcinoma [according the eighth edition of the tumor-node-metastasis (TNM) classification] with MP pattern who underwent complete surgical resection between January 2010 and December 2019. Patients were classified into 3 groups based on the proportion of MP component (10% and 50% as the threshold): MP component >50% (n=8), 10-50% (n=273) and <10% (n=131).

Results: Among the 412 patients, the median age was 63 years, and 73.4% (113/154) patients with MP component ≥10% and 63.8% (51/80) of those with MP component <10% had epidermal growth factor receptor (EGFR) mutations. Patients with MP component >50% had a shorter overall survival (OS) compared with those with MP components of 10-50% [10-50% vs. >50%: hazard ratio (HR) =0.293, 95% confidence interval (CI): 0.083-1.027; P=0.052] or <10% (<10% vs. >50%: HR =0.214, 95% CI: 0.056-0.816; P=0.02). Notably, in the univariate analysis, the factors associated with a worse recurrence-free survival (RFS) were spread-through-air-space (STAS) status (HR =2.131, 95% CI: 1.104-4.112; P=0.02), male sex (HR =1.693, 95% CI: 1.048-2.735; P=0.03), smoking history (HR =1.817, 95% CI: 1.126-2.931; P=0.01), and tumor size >2 cm (HR =1.832, 95% CI: 1.138-2.949; P=0.01).

Conclusions: MP component and risk factors might be considered critical features for patients with stage I lung adenocarcinomas and may inform the selection of patients who may benefit from adjuvant chemotherapy although no randomized evidence is available.

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一项真实世界的多中心研究：切除的I期肺腺癌患者的微乳头形态和危险因素的预后意义以及辅助治疗的可能获益

背景：微乳头状（MP）模式已被确定为肺腺癌患者的不良预后因素，但尚未被认为是IB期肺腺癌辅助化疗患者的高危因素。本多中心队列研究旨在评估I期肺腺癌组织学亚型的预后价值，并确定基于MP模式的亚组辅助化疗的相对生存获益。方法：本回顾性研究纳入了2010年1月至2019年12月412例MP型I期肺腺癌患者（根据第八版肿瘤-淋巴结-转移（TNM）分类），全部手术切除。根据MP成分的比例（以10%和50%为阈值）将患者分为3组：MP成分>50% （n=8), 10-50% （n=273）。结果：412例患者中位年龄为63岁，73.4%（113/154）的患者MP成分≥10%，63.8%（51/80）的患者MP成分EGFR）突变。与MP成分为>50%的患者相比，MP成分为>50%的患者总生存期（OS）较短[10-50% vs. >50%：风险比(HR) =0.293, 95%可信区间（CI）： 0.083-1.027；P=0.052]或vs. >50%: HR =0.214, 95% CI: 0.056 ~ 0.816；P = 0.02)。值得注意的是，在单因素分析中，与较差的无复发生存（RFS）相关的因素是扩散-空间（STAS）状态(HR =2.131, 95% CI: 1.104-4.112；P=0.02)，男性(HR =1.693, 95% CI: 1.048 ~ 2.735；P=0.03)、吸烟史(HR =1.817, 95% CI: 1.126 ~ 2.931；P=0.01)，肿瘤大小bbb2 cm (HR =1.832, 95% CI: 1.138 ~ 2.949；P = 0.01)。结论：尽管没有随机证据，但MP成分和危险因素可能被认为是I期肺腺癌患者的关键特征，并可能为选择可能受益于辅助化疗的患者提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational lung cancer research Medicine-Oncology

CiteScore

7.20

自引率

2.50%

发文量

137

期刊介绍： Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.