Pro: “Is spread through air spaces an in vivo phenomenon or an inducible artifact?” Editorial

  


Authors: Li, Y.; Adusumilli, P. S.; Chou, T. Y.; Kadota, K.; Mino-Kenudson, M.; Papotti, M.; Rekhtman, N.; Yagi, Y.; Yatabe, Y.; Travis, W. D.
Title: Pro: “Is spread through air spaces an in vivo phenomenon or an inducible artifact?”
Abstract: In this PRO-CON debate, you will read very different perspectives about a simple question regarding an observation under the microscope: What is the significance of tumor cells in the air spaces of the lung parenchyma beyond the tumor edge of a resected lung cancer? An important underlying question is whether this entire PRO-CON debate is a mere academic exercise or whether spread through air spaces (STAS), as currently defined, describes a clinically useful phenomenon. The journey of STAS began with a complete paradigm shift to reverse the thinking that all air space tumor cells beyond the edge of lung cancers are an artifact. This led to a new concept where STAS could be separated from artifacts with a definition that has proven to be clinically useful. As with any major change in thinking, it is understandable that there would be some disagreement with this paradigm shift. Nevertheless, after a decade since it was described, many pathologists and clinicians around the world have found STAS to provide important information about the behavior of lung cancer. Numerous PRO-STAS articles supporting the usefulness of STAS have been published with clinical data on many thousands of patients from numerous institutions all over the world. In contrast, for the CON-STAS articles, widespread international representation and data are limited. It is now difficult to ignore the numerous reports and is reasonable to consider how to use the presence of STAS in clinical decisions. Hopefully, this PRO-CON debate will further stimulate clinical and scientific investigations aimed at a better understanding of STAS. © 2024 International Association for the Study of Lung Cancer
Keywords: survival; cancer chemotherapy; metaplasia; antibiotic agent; cancer surgery; pathogenesis; cancer recurrence; squamous cell carcinoma; cancer growth; cancer staging; lymph node metastasis; disease association; metastasis; lung cancer; editorial; in vivo study; cancer mortality; neuroendocrine tumor; pneumonia; lung metastasis; lung adenocarcinoma; cancer classification; frozen section; lung biopsy; lobectomy; circulating tumor cell; stage; interrater reliability; lung parenchyma; ground glass opacity; tumor-associated macrophage; tumor invasion; peribronchiolar metaplasia; prognosis; human; spread through air spaces; stas; spread through air space; image artifact
Journal Title: Journal of Thoracic Oncology
Volume: 19
Issue: 5
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2024-05-01
Start Page: 677
End Page: 697
Language: English
DOI: 10.1016/j.jtho.2024.03.001
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85190544833&doi=10.1016%2fj.jtho.2024.03.001&partnerID=40&md5=7dd128bc681fb3551b90f3b61e5b3b5f
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author is William D. Travis -- Source: Scopus
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MSK Authors
  1. Natasha Rekhtman
    424 Rekhtman
  2. William D Travis
    743 Travis
  3. Prasad S Adusumilli
    496 Adusumilli
  4. Yukako Yagi
    74 Yagi
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