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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2023

23-05-2023 | Thoracic Oncology

A Multi-institutional Analysis of the Combined Effect of Micropapillary Component and Consolidation-to-Tumor Ratio >0.5 on the Prognosis of Pathological, Stage IA3, Lung Adenocarcinoma

Authors: Shao-jun Xu, MD, Jia-hua Tu, MD, Hui Chen, MD, Ren-he Yan, MD, Rui-qin Chen, MD, Chao Chen, MD, Cheng-xiong You, MD, Zhi-fan Zhang, MD, Shao-bin Yu, MD, Shu-chen Chen, PD

Published in: Annals of Surgical Oncology | Issue 9/2023

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Abstract

Introduction

The study investigated the synergistic effect of the micropapillary (MIP) component and consolidation-to-tumor ratio (CTR) on the recurrence and survival of patients with pathologic stage IA3 lung adenocarcinoma.

Methods

We enrolled 419 patients confirmed pathological stage IA3 adenocarcinoma from four institutions. Kaplan–Meier analysis was performed to examine the value of the MIP component and CTR on relapse-free survival (RFS) and overall survival (OS). The cumulative recurrence between different stages was analyzed by using cumulative event curves.

Results

RFS (P < 0.0001) and OS (P = 0.008) in the presence of the MIP group were significantly lower than those in the absence of the MIP group, and CTR > 5 only reduced RFS (P = 0.0004), but not OS (P = 0.063), in the patients. In addition, the prognosis of patients with both the MIP component and CTR > 5 was worse than that of those without the MIP component or CTR ≤ 5. Therefore, we established new subtypes of the stage IA3: IA3a, IA3b, and IA3c. RFS and OS for IA3c staging were significantly lower than those for IA3a and IA3b. For IA3c, the cumulative incidence of local recurrence (P < 0.001) and that of distant metastasis (P = 0.004) were significantly higher than those for IA3a and IA3b.

Conclusions

The MIP component combined with CTR > 0.5 can effectively predict the prognosis of patients with pathological stage IA3 lung adenocarcinoma and may offer more detailed recurrence and survival information according to the established subtype stage of IA3.
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Metadata
Title
A Multi-institutional Analysis of the Combined Effect of Micropapillary Component and Consolidation-to-Tumor Ratio >0.5 on the Prognosis of Pathological, Stage IA3, Lung Adenocarcinoma
Authors
Shao-jun Xu, MD
Jia-hua Tu, MD
Hui Chen, MD
Ren-he Yan, MD
Rui-qin Chen, MD
Chao Chen, MD
Cheng-xiong You, MD
Zhi-fan Zhang, MD
Shao-bin Yu, MD
Shu-chen Chen, PD
Publication date
23-05-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-13658-2

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