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Open Access 01-12-2021 | Research

Locoregional recurrence via mucus-mediated extension following lung resection for mucinous tumors

Authors: Yo Kawaguchi, Jun Hanaoka, Yasuhiko Ohshio, Keigo Okamoto, Ryosuke Kaku, Kazuki Hayashi, Takuya Shiratori, Akira Akazawa, Mitsuaki Ishida

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

Clinically, locoregional recurrences following mucinous tumor resection are often experienced. However, it remains unclear whether mucinous tumors directly affect local recurrence or not, and if so, the mechanism is not known. Therefore, we investigated whether mucinous tumors are associated with locoregional recurrence after pulmonary resection and whether mucus extension is a risk factor for locoregional recurrence.

Methods

The data of 152 patients who underwent pulmonary resection for metastases were reviewed. When mucus was partially or wholly present in the tumor based on macro- or microscopic identification, we assigned the tumor as mucinous. In mucinous tumors, when mucus was identified within the air spaces in the normal lung parenchyma, beyond the edge of the tumor, we assigned the tumor as positive for “mucus extension.”

Results

The 5-year cumulative incidence of locoregional recurrence in patients with mucinous tumors was 48.1%, which was significantly higher than that observed in those with non-mucinous tumors (14.9%). Within the mucinous tumor, the presence of mucus extension beyond the tumor edge was an independent risk factor for locoregional recurrence after pulmonary resection (hazard ratio, 5.52; P = 0.019).

Conclusions

During the resection of mucinous cancer, surgeons should maintain sufficient distance from the tumor edge to prevent locoregional recurrences.

Kawaguchi Y, Hanaoka J, Ohshio Y, Okamoto K, Kaku R, Hayashi K, et al. Survival and prognostic factors in patients undergoing extended pulmonary metastasectomy. Mol Clin Oncol. 2020;13(5):48. https://doi.org/10.3892/mco.2020.2118.CrossRefPubMedPubMedCentral

Kadota K, Nitadori J, Sima CS, Ujiie H, Rizk NP, Jones DR, et al. Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stage I lung adenocarcinomas. J Thorac Oncol. 2015;10(5):806–14. https://doi.org/10.1097/JTO.0000000000000486.CrossRefPubMedPubMedCentral

Shiono S, Ishii G, Nagai K, Yoshida J, Nishimura M, Murata Y, et al. Histopathologic prognostic factors in resected colorectal lung metastases. Ann Thorac Surg. 2005;79(1):278–82. https://doi.org/10.1016/j.athoracsur.2004.06.096.CrossRefPubMed

Shiono S, Ishii G, Nagai K, Murata Y, Tsuta K, Nitadori J, et al. Immunohistochemical prognostic factors in resected colorectal lung metastases using tissue microarray analysis. Eur J Surg Oncol. 2006;32(3):308–9. https://doi.org/10.1016/j.ejso.2005.12.003.CrossRefPubMed

Shiono S, Ishii G, Nagai K, Yoshida J, Nishimura M, Murata Y, et al. Predictive factors for local recurrence of resected colorectal lung metastases. Ann Thorac Surg. 2005;80(3):1040–5. https://doi.org/10.1016/j.athoracsur.2004.12.033.CrossRefPubMed

Kepil N, Batur S, Goksel S. Immunohistochemical and genetic features of mucinous and signet-ring cell carcinomas of the stomach, colon and rectum: a comparative study. Int J Clin Exp Pathol. 2019;12(9):3483–91.PubMedPubMedCentral

Lan YT, Chang SC, Yang SH, Lin CC, Wang HS, Jiang JK, et al. Comparison of clinicopathological characteristics and prognosis between early and late recurrence after curative surgery for colorectal cancer. Am J Surg. 2014;207(6):922–30. https://doi.org/10.1016/j.amjsurg.2013.08.035.CrossRefPubMed

Kawaguchi Y, Hanaoka J, Ohshio Y, Okamoto K, Kaku R, Hayashi K, et al. Patient survival after surgical Management in Intrathoracic Pseudomyxoma peritonei. Ann Surg Oncol. 2019;26(1):238–43. https://doi.org/10.1245/s10434-018-6991-7.CrossRefPubMed

Dong Y, Zhou L, Zhao D, Li K, Liu Z, Che N, et al. MUC5AC enhances tumor heterogeneity in lung adenocarcinoma with mucin production and is associated with poor prognosis. Jpn J Clin Oncol. 2020;21:5742631.

10.

Aronsson L, Bengtsson A, Toren W, Andersson R, Ansari D. Intraductal papillary mucinous carcinoma versus pancreatic ductal adenocarcinoma: a systematic review and meta-analysis. Int J Surg. 2019;71:91–9. https://doi.org/10.1016/j.ijsu.2019.09.014.CrossRefPubMed

11.

Stolnicu S, Hoang L, Soslow RA. Recent advances in invasive adenocarcinoma of the cervix. Virchows Arch. 2019;475(5):537–49. https://doi.org/10.1007/s00428-019-02601-0.CrossRefPubMedPubMedCentral

12.

Chen RF, Tao X, Wu BB, Li J, Wang JY, Gu WY, et al. Mucinous borderline ovarian tumors with and without intraepithelial carcinoma: differences in clinicopathologic features and fertility results. J Obstet Gynaecol Res. 2020;11(10):14210.

13.

Ged Y, Chen YB, Knezevic A, Donoghue MTA, Carlo MI, Lee CH, et al. Mucinous tubular and spindle-cell carcinoma of the kidney: clinical features, genomic profiles, and treatment outcomes. Clin Genitourin Cancer. 2019;17(4):268–74. https://doi.org/10.1016/j.clgc.2019.04.006.CrossRefPubMedPubMedCentral

14.

Wang J, Guli QR, Ming XC, Zhou HT, Cui YJ, Jiang YF, et al. Primary mucinous carcinoma of thyroid gland with prominent signet-ring-cell differentiation: a case report and review of the literature. Onco Targets Ther. 2018;11:1521–8. https://doi.org/10.2147/OTT.S158975 eCollection 2018.CrossRefPubMedPubMedCentral

15.

Younes RN, Fares AL, Gross JL. Pulmonary metastasectomy: a multivariate analysis of 440 patients undergoing complete resection. Interact Cardiovasc Thorac Surg. 2012;14(2):156–61. https://doi.org/10.1093/icvts/ivr076.CrossRefPubMed

Title: Locoregional recurrence via mucus-mediated extension following lung resection for mucinous tumors
Authors: Yo Kawaguchi
Jun Hanaoka
Yasuhiko Ohshio
Keigo Okamoto
Ryosuke Kaku
Kazuki Hayashi
Takuya Shiratori
Akira Akazawa
Mitsuaki Ishida
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-08231-7

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Abstract

Background

Methods

Results

Conclusions

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