|Risk factors of recurrence for resected T1aN0M0 invasive lung adenocarcinoma: a clinicopathologic study of 177 patients|
|Yang, Fan1; Chen, Kezhong1; Liao, Yida1; Li, Xiao1; Sun, Kunkun2; Bao, Dongmei2; Wang, Jun1|
|关键词||Lung adenocarcinoma Recurrence New classification Solid predominant adenocarcinoma Micropapillary predominant adenocarcinoma|
|刊名||WORLD JOURNAL OF SURGICAL ONCOLOGY|
|WOS标题词||Science & Technology|
|类目[WOS]||Oncology ; Surgery|
|研究领域[WOS]||Oncology ; Surgery|
|关键词[WOS]||CLINICAL-PRACTICE GUIDELINES ; VISCERAL PLEURAL INVASION ; ED AMERICAN-COLLEGE ; STAGE-I ; IASLC/ATS/ERS CLASSIFICATION ; INTERNATIONAL-ASSOCIATION ; PROGNOSTIC-SIGNIFICANCE ; LIMITED-RESECTION ; CANCER DIAGNOSIS ; PULMONARY ADENOCARCINOMA|
Background: This study aimed at identifying risk factors of recurrence for completely resected pathologic T1aN0M0 lung adenocarcinomas.
Methods: We reviewed the records of 177 T1aN0M0 invasive adenocarcinoma patients, and re-classified achieved surgical specimens according to the new International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) lung adenocarcinoma classification. Impact on recurrence-free survival (RFS) for age, gender, smoking history, lymphovascular invasion (LVI) and new classification was analyzed by log-rank test and Cox regression. Two existing prognostic grouping schemes of new classification were compared, and subsequently, the correlation of high-grade group in the better prognostic grouping model with clinical data was investigated statistically.
Results: The 5-year recurrence-free rate was 83.7%. The LVI and new adenocarcinoma classification were significantly associated with 5-year RFS (P = 0.012; P = 0.022, respectively). The designation of papillary predominant subtype in the low-grade group, along with lepidic-and acinar predominant subtype had more prognostic significance than the model of combining papillary-, solid- and micropapillary predominant subtypes as the high-grade group (P = 0.005 versus P = 0.181). This high-grade group has increased risk of recurrence in a multivariate Cox regression (adjusted HR 2.815, 95% CI: 1.239 to 6.397, P = 0.013), and is associated significantly more with male gender (adjusted OR 2.214, 95% CI: 1.050 to 4.668, P = 0.037), and, with borderline significance, the presence of LVI (adjusted OR 2.091, 95% CI: 0.938 to 4.662, P = 0.071).
Conclusions: Our results showed that the solid-and micropapillary predominant subtype of IASLC/ATS/ERS classification remains the only risk factor for post-operative recurrence of T1aN0M0 adenocarcinomas, suggesting that they can be indicators of aggressive tumor behaviors.
|作者单位||1.Peking Univ, Peoples Hosp, Dept Thorac Surg, Beijing 100044, Peoples R China|
2.Peking Univ, Peoples Hosp, Dept Pathol, Beijing 100044, Peoples R China
|Yang, Fan,Chen, Kezhong,Liao, Yida,et al. Risk factors of recurrence for resected T1aN0M0 invasive lung adenocarcinoma: a clinicopathologic study of 177 patients[J]. WORLD JOURNAL OF SURGICAL ONCOLOGY,2014,12.|
|APA||Yang, Fan.,Chen, Kezhong.,Liao, Yida.,Li, Xiao.,Sun, Kunkun.,...&Wang, Jun.(2014).Risk factors of recurrence for resected T1aN0M0 invasive lung adenocarcinoma: a clinicopathologic study of 177 patients.WORLD JOURNAL OF SURGICAL ONCOLOGY,12.|
|MLA||Yang, Fan,et al."Risk factors of recurrence for resected T1aN0M0 invasive lung adenocarcinoma: a clinicopathologic study of 177 patients".WORLD JOURNAL OF SURGICAL ONCOLOGY 12(2014).|