High-risk features associated with recurrence in stage I lung adenocarcinoma Journal Article
| Authors: | Fick, C. N.; Dunne, E. G.; Vanstraelen, S.; Toumbacaris, N.; Tan, K. S.; Rocco, G.; Molena, D.; Huang, J.; Park, B. J.; Rekhtman, N.; Travis, W. D.; Chaft, J. E.; Bott, M. J.; Rusch, V. W.; Adusumilli, P. S.; Sihag, S.; Isbell, J. M.; Jones, D. R. |
| Article Title: | High-risk features associated with recurrence in stage I lung adenocarcinoma |
| Abstract: | Objective: There is a lack of knowledge regarding the use of prognostic features in stage I lung adenocarcinoma (LUAD). Thus, we investigated clinicopathologic features associated with recurrence after complete resection for stage I LUAD. Methods: We performed a retrospective analysis of patients with pathologic stage I LUAD who underwent R0 resection from 2010 to 2020. Exclusion criteria included history of lung cancer, induction or adjuvant therapy, noninvasive or mucinous LUAD, and death within 90 days of surgery. Fine and Gray competing-risk regression assessed associations between clinicopathologic features and disease recurrence. Results: In total, 1912 patients met inclusion criteria. Most patients (1565 [82%]) had stage IA LUAD, and 250 developed recurrence: 141 (56%) distant and 109 (44%) locoregional only. The 5-year cumulative incidence of recurrence was 12% (95% CI, 11%-14%). Higher maximum standardized uptake value of the primary tumor (hazard ratio [HR], 1.04), sublobar resection (HR, 2.04), higher International Association for the Study of Lung Cancer grade (HR, 5.32 [grade 2]; HR, 7.93 [grade 3]), lymphovascular invasion (HR, 1.70), visceral pleural invasion (HR, 1.54), and tumor size (HR, 1.30) were independently associated with a hazard of recurrence. Tumors with 3 to 4 high-risk features had a higher cumulative incidence of recurrence at 5 years than tumors without these features (30% vs 4%; P < .001). Conclusions: Recurrence after resection for stage I LUAD remains an issue for select patients. Commonly reported clinicopathologic features can be used to define patients at high risk of recurrence and should be considered when assessing the prognosis of patients with stage I disease. © 2024 The American Association for Thoracic Surgery |
| Keywords: | adult; aged; middle aged; cancer surgery; primary tumor; retrospective studies; major clinical study; clinical feature; histopathology; mortality; cancer recurrence; cancer risk; cancer patient; cancer staging; neoplasm staging; neoplasm recurrence, local; tumor volume; lung neoplasms; pneumonectomy; risk factors; recurrence; pathology; retrospective study; risk factor; time factors; risk assessment; lung tumor; lung adenocarcinoma; tumor recurrence; surgery; epidemiology; cumulative incidence; adenocarcinoma of lung; time factor; lymphovascular invasion; high risk; visceral pleural invasion; maximum standardized uptake value; lymph vessel metastasis; humans; human; male; female; article; suvmax; iaslc grade; stage i lung adenocarcinoma |
| Journal Title: | Journal of Thoracic and Cardiovascular Surgery |
| Volume: | 169 |
| Issue: | 2 |
| ISSN: | 0022-5223 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2025-02-01 |
| Start Page: | 436 |
| End Page: | 444.e6 |
| Language: | English |
| DOI: | 10.1016/j.jtcvs.2024.05.009 |
| PUBMED: | 38788834 |
| PROVIDER: | scopus |
| PMCID: | PMC11582076 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: David R. Jones -- Source: Scopus |
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