Clinical Implication of Minimal Presence of Solid or Micropapillary Subtype in Early-stage Lung Adenocarcinoma

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2020 Nov 24

PMID 33231358

Citations 23

Authors

Sun Ha Choi

Ji Yun Jeong

Shin Yup Lee

Kyung Min Shin

Shin Young Jeong

Tae-In Park

Young Woo Do

Eung Bae Lee

Yangki Seok

Won Kee Lee

Ji Eun Park

Sunji Park

Yong Hoon Lee

Hyewon Seo

Seung Soo Yoo

Jaehee Lee

Seung-Ick Cha

Chang Ho Kim

Jae Yong Park

Affiliations

Soon will be listed here.

Abstract

Background: We investigated the clinical features and surgical outcomes of lung adenocarcinoma with minimal solid or micropapillary (S/MP) components, with a focus on stage IA.

Methods: We enrolled 506 patients with lung adenocarcinoma who underwent curative resection in this study. Clinical features and surgical outcomes were compared between the groups with and without the S/MP subtype (S/MP+ and S/MP-, respectively), and between the group with an S/MP proportion of ≤5% (S/MP5) and the S/MP-.

Results: The S/MP subtype was present in 247 patients (48.8%); 129 (25.5%) were grouped as the S/MP5 group. The S/MP+ and S/MP5 groups had larger tumors, higher frequency of lymph node metastasis, and more advanced stages of disease than the S/MP- group (P < 0.001, all comparisons). Pleural, lymphatic, and vascular invasions occurred more frequently in the S/MP+ and S/MP5 groups (P < 0.001, all comparisons for S/MP+ vs. S/MP-; P ≤ 0.01, all comparisons for S/MP5 vs. S/MP-). The S/MP+ and S/MP5 groups showed a shorter time to recurrence and cancer-related death than the S/MP- group(P < 0.001, both comparisons). For stage I, the presence or absence of the S/MP subtype defined prognostic subgroups better than the stage IA/IB classification. Notably, in the multivariate analysis, the minimal S/MP component was a significant predictor of recurrence, even in stage IA.

Conclusions: The presence of the minimal S/MP component was a significant predictor of poor prognosis after surgery, even in stage IA patients. Clinical trials to evaluate the advantages of adjuvant chemotherapy for this subset of patients and further investigations to understand underlying biological mechanisms of poor prognosis are needed.

Key Points: Significant findings of the study: We demonstrated that only minimal presence of solid or micropapillary component was profoundly associated with aggressive clinicopathological features and poor prognosis after complete resection even in stage IA lung adenocarcinoma.

What This Study Adds: Our results suggest that minimal presence of these subtypes is a strong prognostic factor which should be taken into account in the risk assessment for adjuvant chemotherapy in lung adenocarcinoma.

Citing Articles

Risk Stratification and Adjuvant Chemotherapy for High-Risk Stage IA Lung Adenocarcinoma: The Unmet Needs.

Shen C, Liu H, Li B, Wang J, Wang Y, Bao F Thorac Cancer. 2024; 16(2):e15521.

PMID: 39707836 PMC: 11735727. DOI: 10.1111/1759-7714.15521.

Predicting prognosis in patients with stage IA lung adenocarcinoma with a micropapillary component using a nomogram based on computed tomography radiomics and clinicopathologic factors: a retrospective analysis.

Li Y, Zhao J, Li R, Yao X, Dong X, Zhao Y Transl Lung Cancer Res. 2024; 13(10):2585-2602.

PMID: 39507031 PMC: 11535836. DOI: 10.21037/tlcr-24-544.

Deep learning-based characterization of pathological subtypes in lung invasive adenocarcinoma utilizing F-deoxyglucose positron emission tomography imaging.

Wu D, Li Y, Zhou M, Gong F, Li J BMC Cancer. 2024; 24(1):1229.

PMID: 39369213 PMC: 11453012. DOI: 10.1186/s12885-024-13018-7.

The impact of postoperative adjuvant therapy on EGFR-mutated stage IA lung adenocarcinoma with micropapillary pathological subtypes.

Cheng R, Hao Z, Qiu L, Zheng X, Huang S, Xian J World J Surg Oncol. 2024; 22(1):235.

PMID: 39232762 PMC: 11375949. DOI: 10.1186/s12957-024-03429-y.

Sublobar resection for lung adenocarcinoma less than 2 cm containing solid or micropapillary components radiologically presented as consolidation-to-tumor ratio (CTR) ≤0.25 [ground-glass opacity (GGO)].

Zhu M, Xu Y, Huang J, Yao Y, Tosi D, Koike T Transl Lung Cancer Res. 2024; 13(7):1685-1694.

PMID: 39118896 PMC: 11304140. DOI: 10.21037/tlcr-24-231.

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