Solid predominant histologic subtype in resected stage I lung adenocarcinoma is an independent predictor of early, extrathoracic, multisite recurrence and of poor postrecurrence survival Journal Article


Authors: Ujiie, H.; Kadota, K.; Chaft, J. E.; Buitrago, D.; Sima, C. S.; Lee, M. C.; Huang, J.; Travis, W. D.; Rizk, N. P.; Rudin, C. M.; Jones, D. R.; Adusumilli, P. S.
Article Title: Solid predominant histologic subtype in resected stage I lung adenocarcinoma is an independent predictor of early, extrathoracic, multisite recurrence and of poor postrecurrence survival
Abstract: PURPOSE: To examine the significance of the proposed International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) histologic subtypes of lung adenocarcinoma for patterns of recurrence and, among patients who recur following resection of stage I lung adenocarcinoma, for postrecurrence survival (PRS). PATIENTS AND METHODS: We reviewed patients with stage I lung adenocarcinoma who had undergone complete surgical resection from 1999 to 2009 (N = 1,120). Tumors were subtyped by using the IASLC/ATS/ERS classification. The effects of the dominant subtype on recurrence and, among patients who recurred, on PRS were investigated. RESULTS: Of 1,120 patients identified, 188 had recurrent disease, 103 of whom died as a result of lung cancer. Among patients who recurred, 2-year PRS was 45%, and median PRS was 26.1 months. Compared with patients with nonsolid tumors, patients with solid predominant tumors had earlier (P = .007), more extrathoracic (P < .001), and more multisite (P = .011) recurrences. Multivariable analysis of primary tumor factors revealed that, among patients who recurred, solid predominant histologic pattern in the primary tumor (hazard ratio [HR], 1.76; P = .016), age older than 65 years (HR, 1.63; P = .01), and sublobar resection (HR, 1.6; P = .01) were significantly associated with worse PRS. Presence of extrathoracic metastasis (HR, 1.76; P = .013) and age older than 65 years at the time of recurrence (HR, 1.7; P = .014) were also significantly associated with worse PRS. CONCLUSION: In patients with stage I primary lung adenocarcinoma, solid predominant subtype is an independent predictor of early recurrence and, among those patients who recur, of worse PRS. Our findings provide a rationale for investigating adjuvant therapy and identify novel therapeutic targets for patients with solid predominant lung adenocarcinoma. © 2015 by American Society of Clinical Oncology.
Keywords: adult; aged; aged, 80 and over; middle aged; mortality; cancer staging; neoplasm staging; adenocarcinoma; neoplasm recurrence, local; lung neoplasms; pathology; tumor recurrence; very elderly; humans; human; male; female
Journal Title: Journal of Clinical Oncology
Volume: 33
Issue: 26
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2015-09-10
Start Page: 2877
End Page: 2884
Language: English
DOI: 10.1200/jco.2015.60.9818
PUBMED: 26261257
PROVIDER: scopus
PMCID: PMC4554749
DOI/URL:
Notes: Article -- Export Date: 2 June 2016 -- Source: Scopus
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MSK Authors
  1. Camelia S Sima
    204 Sima
  2. Nabil Rizk
    134 Rizk
  3. James Huang
    119 Huang
  4. Jamie Erin Chaft
    127 Chaft
  5. William D Travis
    552 Travis
  6. Kyuichi Kadota
    82 Kadota
  7. Ming-Ching Lee
    6 Lee
  8. Hideki Ujiie
    11 Ujiie
  9. Charles Rudin
    166 Rudin
  10. David Randolph Jones
    153 Jones