Clinical Research Papers:
Solid predominant histologic subtype and early recurrence predict poor postrecurrence survival in patients with stage I lung adenocarcinoma
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Jizhuang Luo1,*, Rui Wang1,*, Baohui Han2, Jie Zhang3, Heng Zhao1, Wentao Fang1, Qingquan Luo4, Jun Yang1, Yunhai Yang1, Lei Zhu3, Tianxiang Chen1, Xinghua Cheng5, Qingyuan Huang1, Yiyang Wang1, Jiajie Zheng1 and Haiquan Chen1,5,6,7
1 Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
2 Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
3 Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
4 Department of Shanghai Lung Tumor Clinic Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
5 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
6 Institutes of Biomedical Sciences, Fudan University, Shanghai, China
7 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
* These authors have contributed equally to this work
Haiquan Chen, email:
Keywords: invasive lung adenocarcinoma; non-small cell lung cancer; postrecurrence survival; solid; stage I
Received: July 25, 2016 Accepted: September 22, 2016 Published: October 09, 2016
Introduction: This study investigated the correlation between histologic predominant pattern and postrecurrence survival (PRS), and identified the clinicopathologic factors influencing PRS in patients with completely resected stage I lung adenocarcinoma.
Methods: A total of 136 stage I lung adenocarcinoma patients who experienced tumor recurrence after completely resection were included in this study. To analysis the association between histologic predominant pattern and PRS, invasive adenocarcinomas with mixed histologic components were divided into 2 groups: solid and nonsolid group (including lepidic, acinar, papillary, micropapillary) based on the histologic predominant pattern. PRS was analyzed to identify the prognostic predictors using the Kaplan-Meier approach and multivariable Cox models.
Results: For all stage I invasive adenocarcinoma patients, the majority of postsurgical recurrences occurred within 2 years. Patients with solid predominant histological pattern were associated with unfavorable PRS (HR, 2.40; 95%CI 1.13-5.08, p=.022). There was a significant difference for poor PRS for patients who diagnosed tumor recurrence shorter than 12 months after surgery (HR, 2.34; 95%CI 1.12-4.90, p=.024). Extrathoracic metastasis was associated with poor media PRS in univariable analysis (p =.011), however, there was no significant PRS difference in multivariable analysis (HR, 1.56; 95%CI 0.65-3.73, p=.322) compared with intrathoracic metastasis.
Conclusions: Solid predominant histologic subtype and recurrence free interval less than 12 months predict worse PRS in patients with stage I lung adenocarcinoma.
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