The International Association for the Study of Lung Cancer (IASLC) Staging Project for Lung Cancer: Recommendation to Introduce Spread Through Air Spaces as a Histologic Descriptor in the Ninth Edition of the TNM Classification of Lung Cancer. Analysis of 4061 Pathologic Stage I NSCLC

医学 肺癌 淋巴血管侵犯 腺癌 单变量分析 阶段(地层学) 癌症 放射科 病理 肿瘤科 内科学 多元分析 转移 生物 古生物学
作者
William D. Travis,Megan Eisele,Katherine K. Nishimura,Rania G. Aly,Pietro Bertoglio,Teh‐Ying Chou,Frank C. Detterbeck,Jessica Donnington,Wentao Fang,Philippe Joubert,Kemp H. Kernstine,Young Tae Kim,Yolande Lievens,Hui Liu,Gustavo Lyons,Mari Mino–Kenudson,Andrew G. Nicholson,Mauro Papotti,Ramón Rami–Porta,Valerie W. Rusch
出处
期刊:Journal of Thoracic Oncology [Elsevier BV]
卷期号:19 (7): 1028-1051 被引量:30
标识
DOI:10.1016/j.jtho.2024.03.015
摘要

Spread through air spaces (STAS) consists of lung cancer tumor cells that are identified beyond the edge of the main tumor in the surrounding alveolar parenchyma.It has been reported by meta-analyses to be an independent prognostic factor in the major histologic types of lung cancer, but its role in lung cancer staging is not established.To assess the clinical importance of STAS in lung cancer staging, we evaluated 4061 surgically resected pathologic Stage I R0 nonsmall cell carcinomas (NSCLC) collected from around the world in the IASLC database.We focused on whether STAS could be a useful additional histologic descriptor to supplement the existing ones of visceral pleural invasion (VPI) and lymphovascular invasion (LVI).STAS was found in 930/4061 of the pathologic stage I NSCLC (22.9%).Patients with tumors exhibiting STAS had a significantly worse recurrence free and overall survival in both univariate and multivariable analyses involving cohorts consisting of all NSCLC, specific histologic types (adenocarcinoma and other NSCLC), and extent of resection (lobar and sublobar).Interestingly, STAS was independent of VPI in all of these analyses.These data support our recommendation to include STAS as a histologic descriptor for the 9 th Edition of the TNM Classification of lung cancer.Hopefully gathering this data in the coming years will facilitate a thorough analysis to better understand the relative impact of STAS, LVI and VPI on lung cancer staging for the 10 th Edition TNM Stage Classification.
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