NSCLC: STAS associated with poorer outcomes after SR

  • Ren Y & al.
  • Ann Surg Oncol
  • 18 mars 2019

  • Par Kelli Whitlock Burton
  • Résumés d'articles
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Takeaway

  • Tumor spread through air spaces (STAS) is associated with worse recurrence-free survival (RFS) and OS in patients with stage 1A NSCLC undergoing sublobar resection (SR).
  • STAS was not a prognostic factor with lobectomy.

Why this matters

  • STAS has recently been identified as a risk factor for poor prognosis, but little is known about its prognostic effect by resection type.

Study design

  • Patients with stage 1A NSCLC underwent lobectomy (n=634) or SR (n=118).
  • Funding: Shanghai Hospital Development Center; Fundamental Research Funds for the Central Universities; and others.

Key results

  • 28.7% of the lobectomy group and 36.4% of the SR group had STAS.
  • STAS was associated with worse RFS and OS in SR patients (HR, 3.529 [P<.001 and hr but not in lobectomy patients p=".052," respectively>
  • STAS was more likely in patients with micropapillary predominant adenocarcinoma (P<.001 and a tumor-margin distance of cm>
  • Patients with disease in the T1c category had a significantly higher risk for STAS in residual lung segments (HR, 5.868; P=.033).
  • In residual lung segments, STAS occurred in 9 of 100 simulated cases.

Limitations

  • Retrospective, single-center study.