دورية أكاديمية
Vascular invasion identifies the most aggressive histologic subset of stage I lung adenocarcinoma: Implications for adjuvant therapy.
| العنوان: | Vascular invasion identifies the most aggressive histologic subset of stage I lung adenocarcinoma: Implications for adjuvant therapy. |
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| المؤلفون: | Yambayev I; Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA., Sullivan TB; Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Hospital & Medical Center, Burlington, MA, USA., Rieger-Christ KM; Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Hospital & Medical Center, Burlington, MA, USA., Servais EL; Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA, USA., Stock CT; Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA, USA., Quadri SM; Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA, USA., Sands JM; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., Suzuki K; Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA., Burks EJ; Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA; Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Hospital & Medical Center, Burlington, MA, USA. Electronic address: ejburks@bu.edu. |
| المصدر: | Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2022 Sep; Vol. 171, pp. 82-89. Date of Electronic Publication: 2022 Jul 25. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8800805 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8332 (Electronic) Linking ISSN: 01695002 NLM ISO Abbreviation: Lung Cancer Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Limerick : Elsevier Scientific Publishers Original Publication: Amsterdam, The Netherlands : Elsevier, c1985- |
| مواضيع طبية MeSH: | Adenocarcinoma*/pathology , Adenocarcinoma of Lung*/pathology , Lung Neoplasms*/drug therapy, Humans ; Male ; Neoplasm Staging ; Prognosis ; Retrospective Studies |
| مستخلص: | Objectives: Approximately 15% of stage I lung adenocarcinomas will recur despite adequate surgical therapy. Adjuvant therapy may benefit specific high-risk subsets; however, it is unclear which patients are sufficiently predisposed to recurrence to warrant intensified therapy. Materials and Methods: 517 AJCC 8th edition stage I/0 lung adenocarcinomas ≤ 4 cm total size were graded (WHO-2015 and WHO-2021) and compared to stage subgroupings using 7-year recurrence free (RFS), disease specific (DSS), and overall survival (OS). Low malignant potential (LMP) adenocarcinoma was assigned as previously defined. Univariate/multivariate analysis was performed to assess risk factors associated with aggressive behavior. Results: Vascular invasion was the most significant histologic feature on multivariate analysis for both RFS (HR = 4.68, p < 0.001) and DSS (HR = 3.67, p = 0.001) and nearly reached significance for OS (HR = 1.47, p = 0.060). Angioinvasive adenocarcinomas comprised 26 % of the cohort and exhibited a 7-year 64 % RFS, 73 % DSS, and 50 % OS; in contrast to 20 % WHO-2015-G3 (7-year 71 % RFS, 79 % DSS, & 54 % OS), 44 % WHO-2021-G3 (7-year 79 % RFS, 85 % DSS, & 56 % OS), and 21 % stage IB (7-year 72 % RFS, 79 % DSS, and 50 % OS) adenocarcinomas. The majority (>50 %) of overall mortality was disease specific for angioinvasive adenocarcinoma whereas ≤25 % of overall mortality was disease specific for the remaining tumors. Angioinvasive adenocarcinomas were proportionally more common among those still smoking at diagnosis (49 %), male sex (49 %), and black race (16 %) than other subtypes. Conclusion: Patients with AJCC 8th ed. stage I angioinvasive lung adenocarcinomas are at high-risk of cancer-specific mortality and should be considered for clinical trials evaluating benefit of adjuvant therapy. (Copyright © 2022 Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Adenocarcinoma; Angioinvasion; LMP; Vascular invasion; WHO grade |
| تواريخ الأحداث: | Date Created: 20220806 Date Completed: 20220817 Latest Revision: 20220824 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.lungcan.2022.07.016 |
| PMID: | 35932520 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1872-8332 |
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| DOI: | 10.1016/j.lungcan.2022.07.016 |