Meta-Analysis:
Clinicopathological and prognostic significance of tumour spread through air spaces in patients with lung cancer: a metaanalysis
Peirui Chen1,2, Mingqiang Diao1,2, Changming Zhao1,2, XiangDong Guo1,2 and Xiaokang Sun1,2
1Deyang People's Hospital, Deyang 618000, China
2Deyang Key Laboratory of Tumor Therapy, Deyang 618000, China
Correspondence to:
Xiaokang Sun, email: [email protected]
Keywords: spread through air spaces; lung cancer; prognosis; clinicopathological parameters; meta-analysis
Received: November 22, 2017 Accepted: April 07, 2018 Published:
ABSTRACT
Background: The prognostic significance of tumour spread through air spaces (STAS) in patients with lung cancer remains a source of controversy. Therefore, the current meta-analysis was conducted, aiming to evaluate the prognostic value of STAS in lung cancer, as well as its relationship with some clinicopathological characteristics.
Methods: Relevant literature was retrieved in the databases including PubMed, EMBASE, Cochrane database, China National Knowledge Internet database, Web of Science, Wanfang database and VIP database up to December 2017. Subsequently, a meta-analysis was thereby performed using Review Manager 5.1.2, with odds ratio (OR), hazard ratio (HR) and 95% confidence interval (CI) as the effect values.
Results: A total of 9 studies involving 3346 patients with lung cancer were analyzed. The pooled OR values showed that STAS was associated with male sex [OR = 1.43, 95% CI (1.10–1.87)], smoking status [OR = 1.67, 95% CI (1.35–2.06)], advanced TNM stage [OR = 2.52, 95% CI (1.95–3.24)], more vascular [OR = 2.73, 95% CI (1.58–4.72)], pleural [OR = 3.07, 95% CI (1.45–6.51)] or lymph [OR = 3.70, 95% CI (2.39–5.72)] invasion, more tumour necroses [OR = 2.37, 95% CI (1.78–3.17)], more micropapillary [OR = 14.35, 95% CI (9.22–22.34)] and papillary [OR = 1.71, 95% CI (1.18–2.46)] patterns, and less lepidic [OR = 0.29, 95% CI (0.21–0.40)] pattern. In addition, the pooled HR values suggested that STAS was remarkably correlated with the shorter overall survival [OS, HR = 1.64, 95% CI (1.31, 2.05)] and shorter recurrence-free survival [RFS, HR = 1.69, 95% CI (1.36–2.11)] in these patients.
Conclusions: The presence of STAS is markedly associated with the unfavorable conditions of tumor invasion, TNM stage, tumor necrosis and pathological pattern. Therefore, STAS can serve as a valuable predictor for the dismal prognosis of lung cancer.