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Optimal Surgery and Treatment Options for Stage 1 Lung Adenocarcinoma/Tumors Spread Through Air Spaces
A study found no difference in survival outcomes between sublobar resection and lobectomy among patients with stage 1 lung adenocarcinoma/tumors spread through air spaces (STAS).
While there is evidence that patients with STAS are at an increased risk of recurrence and shortened survival time, Yilv Lv, MD, Shanghai Jiao Tong University, Shanghai, China, and colleagues wrote, “the impact of surgery procedure and adjuvant treatment on the prognosis of stage I [adenocarcinoma]/STAS-positive patients remains uncertain.”
The study retrospectively identified 600 patients diagnosed with STAS, out of 3328 consecutive patients with stage I ADC, between 2014 and 2018. The study aimed to evaluate the impact of STAS on overall survival (OS) and recurrence-free survival (RFS).
There was no significant difference in either OS (P = .919) or RFS (P = .066) found between patients who underwent sublobar resection and those who underwent lobectomy. Multivariate analysis of sublobar resection vs lobectomy confirmed these results (OS hazard ratio [HR] = 0.523; 95% confidence interval [CI], 0.056 to 18.458; P = .714; RFS HR = 0.36; 95 % CI, 0.115 to 1.565; P = .897). Additionally, while the study found that adjuvant chemotherapy did not improve prognosis for patients with stage 1A lung cancer, it did improve the RFS of patients with state 1B cancer and high-risk recurrence factors (P = .046).
“The results of our study suggest that patients with stage IA [adenocarcinoma]/STAS may not benefit from [adjuvant chemotherapy],” Dr Lv, et al explained. They concluded, “Future analyses with longer follow-up periods and more comprehensive OS data are still needed to confirm these findings.”
Source:
Lv Y, Li S, Liu Z, et al. Impact of surgery and adjuvant chemotherapy on the survival of stage I lung adenocarcinoma patients with tumor spread through air spaces. Lung Cancer. 2023;177:51-58. doi:10.1016/j.lungcan.2023.01.009
