CLINICAL IMPLICATION OF STAS (TUMOR SPREAD THROUGH AIR SPACES) IN STAGE I (AJCC 8TH EDITION) LUNG ADENOCARCINOMA TREATED WITH LOBECTOMY

초록

PURPOSE: The aim of this study is to investigate the clinical implications of STAS as a recurrent risk factor in stage I lung adenocarcinoma treated with lobectomy. METHODS: The medical records of patients who underwent pulmonary lobectomies for their stage I lung adenocarcinomas between 2012 and February 2018 in our institutes were reviewed retrospectively. Patients with minimally invasive adenocarcinomas and more than 3 cm in tumor size were excluded. Included patients were classified as STAS(+) and STAS(-) groups. Clinical implications between STAS and recurrence in those patients were investigated. RESULTS: A total of 109 patients were enrolled in this study and the mean follow-up periods were 37.5 months. Among those, 41 patients (37.6%) were STAS (+) and 68 patients (62.4%) were STAS (-). STAS was associated with larger consolidation diameter in chest tomography (p=0.008) and the presence of micropapillary pattern (p=0.002) in multivariate analysis. The recurrence rates of STAS (+) patients were significantly higher (22.0% vs 4.4%, p=0.009), and the recurrence-free survival periods of those patients were significantly shorter (p=0.008) than the STAS (-) patients. The overall survival periods of both groups showed no statistically significant differences (p=0.961). The presence of STAS was an independent risk factor of recurrence in multivariate analysis (hazard ratio=5.9, p=0.031). CONCLUSIONS: The presence of STAS could be an important risk factor of recurrence in stage I lung adenocarcinoma patients who had treated with pulmonary lobectomies. CLINICAL IMPLICATIONS: Tumor spread through air spaces (STAS) has been known to be a risk factor of recurrence in small lung cancer treated with limited resections. DISCLOSURE: No significant relationships.