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 Journal Article
| Authors: | Travis, W. D.; Eisele, M.; Nishimura, K. K.; Aly, R. G.; Bertoglio, P.; Chou, T. Y.; Detterbeck, F. C.; Donnington, J.; Fang, W.; Joubert, P.; Kernstine, K.; Kim, Y. T.; Lievens, Y.; Liu, H.; Lyons, G.; Mino-Kenudson, M.; Nicholson, A. G.; Papotti, M.; Rami-Porta, R.; Rusch, V.; Sakai, S.; Ugalde, P.; Van Schil, P.; Yang, C. F. J.; Cilento, V. J.; Yotsukura, M.; Asamura, H.; and the Members of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee; Members of the Advisory Boards; and Participating Institutions of the Lung Cancer Domain |
| Contributors: | Huang, J.; Rimner, A.; Chang, J.; Rekhtman, N.; Rocco, G.; Simone, C. B. 2nd; Sauter, J. |
| Article Title: | 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 |
| Abstract: | Introduction: 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. Methods: To assess the clinical importance of STAS in lung cancer staging, we evaluated 4061 surgically resected pathologic stage I R0 NSCLC collected from around the world in the International Association for the Study of Lung Cancer 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). Results: STAS was found in 930 of 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. Conclusions: These data support our recommendation to include STAS as a histologic descriptor for the Ninth Edition of the TNM Classification of Lung Cancer. Hopefully, gathering these 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 Tenth Edition TNM Stage Classification. © 2024 |
| Keywords: | human tissue; aged; overall survival; squamous cell carcinoma; cancer staging; metastasis; tumor volume; lung cancer; histology; tissue section; survival time; lung adenocarcinoma; recurrent disease; adenosquamous carcinoma; univariate analysis; lobectomy; pleura; bronchus tumor; lung lesion; recurrence free survival; non small cell lung cancer; lymphovascular invasion; visceral pleural invasion; lymph vessel metastasis; human; male; female; article; stage classification; segmentectomy; spread through air spaces; histologic descriptor |
| Journal Title: | Journal of Thoracic Oncology |
| Volume: | 19 |
| Issue: | 7 |
| ISSN: | 1556-0864 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2024-07-01 |
| Start Page: | 1028 |
| End Page: | 1051 |
| Language: | English |
| DOI: | 10.1016/j.jtho.2024.03.015 |
| PUBMED: | 38508515 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is William Travis -- Other associations featuring MSK group contributors are listed in the publication's appendix, located on the PDF -- Source: Scopus |
