P06.06 Clinical Implications of Tumour Spread Through Air Spaces (STAS) In Lung Adenocarcinoma Patients Treated With Surgery

2021 ◽  
Vol 16 (10) ◽  
pp. S987
Author(s):  
L. Gutierrez Sainz ◽  
S. Lopez Muñoz ◽  
P. Cruz Castellanos ◽  
M.I. Esteban Rodriguez ◽  
O. Higuera ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Clinical Implications ◽  
Tumour Spread ◽  
Spread Through Air Spaces

scholarly journals Clinical implication of tumour spread through air spaces in pathological stage I lung adenocarcinoma treated with lobectomy

2020 ◽  
Vol 32 (1) ◽  
pp. 64-72
Author(s):  
Eunjue Yi ◽  
Jeong Hyeon Lee ◽  
Younggi Jung ◽  
Jae Ho Chung ◽  
Youngseok Lee ◽  
...  
Keyword(s):  
Risk Factor ◽  
Lung Adenocarcinoma ◽  
Survival Curve ◽  
Multivariable Analysis ◽  
Stage I ◽  
Pulmonary Lobectomy ◽  
Pathological Stage ◽  
Tumour Spread ◽  
Risk Factor For Recurrence ◽  
Spread Through Air Spaces

Abstract OBJECTIVES The aim of this study was to evaluate the clinical implication of tumour spread through air spaces (STAS) as a prognostic factor in pathological stage I lung adenocarcinoma treated with lobectomy and to identify related parameters. METHODS Medical records of patients who underwent pulmonary lobectomy for stage I (American Joint Committee on Cancers eighth edition) lung adenocarcinomas between 2012 and February 2018 at our institutions were reviewed retrospectively. Patients with minimally invasive adenocarcinomas and tumours ≥3 cm in size were excluded. Included patients were classified into STAS (+) and STAS (−) groups. Clinical implications of STAS and recurrence in patients were investigated. RESULTS A total of 109 patients was analysed: 41 (37.6%) in the STAS (+) and 68 (62.4%) in the STAS (−) group. STAS was associated with larger consolidation diameter on chest tomography (≥1.5 cm; P = 0.006) or a higher invasive ratio (≥85%; P = 0.012) and presence of a micropapillary pattern in multivariable analysis (P = 0.003) The recurrence-free survival curve showed statistical difference (P = 0.008) with 3-year survival rates of 73.0% (9 patients) and 96.8% (2 patients) in the STAS (+) and STAS (−) group, respectively. However, no statistical significance was observed in the lung cancer-related survival curve (P = 0.648). The presence of STAS was an independent risk factor for recurrence in multivariable analysis (hazard ratio = 5.9, P = 0.031). CONCLUSIONS The presence of STAS could be an important risk factor for recurrence in patients with early-stage invasive lung adenocarcinoma treated with pulmonary lobectomy.

scholarly journals Radiomics-based prediction for tumour spread through air spaces in stage I lung adenocarcinoma using machine learning

2020 ◽  
Vol 58 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Donglai Chen ◽  
Yunlang She ◽  
Tingting Wang ◽  
Huikang Xie ◽  
Jian Li ◽  
...  
Keyword(s):  
Machine Learning ◽  
Lung Adenocarcinoma ◽  
Naive Bayes ◽  
External Validation ◽  
Area Under The Curve ◽  
Naïve Bayes ◽  
Stage I ◽  
Receiver Operating Curve ◽  
Tumour Spread ◽  
Spread Through Air Spaces

Abstract OBJECTIVES As evidence has proven that sublobar resection is oncologically contraindicated by tumour spread through air spaces (STAS), its preoperative recognition is vital in customizing surgical strategies. We aimed to assess the value of radiomics in predicting STAS in stage I lung adenocarcinoma. METHODS We retrospectively reviewed the patients with stage I lung adenocarcinoma, who accepted curative resection in our institution between January 2011 and December 2013. Using ‘PyRadiomics’ package, 88 radiomics features were extracted from computed tomography (CT) images and a prediction model was consequently constructed using Naïve Bayes machine-learning approach. The accuracy of the model was assessed through receiver operating curve analysis, and the performance of the model was validated both internally and externally. RESULTS A total of 233 patients were included as the training cohort with 69 (29.6%) patients being STAS (+). Patients with STAS had worse recurrence-free survival and overall survival (P < 0.001). After feature extraction, 5 most contributing radiomics features were selected out to develop a Naïve Bayes model. In the internal validation, the model exhibited good performance with an area under the curve value of 0.63 (0.55–0.71). External validation was conducted on a test cohort with 112 patients and produced an area under the curve value of 0.69. CONCLUSIONS CT-based radiomics is valuable in preoperatively predicting STAS in stage I lung adenocarcinoma, which may aid surgeons in determining the optimal surgical approach.

Relationship between Twist, Slug with Tumor Spread Through Air Spaces in Lung Adenocarcinoma

2019 ◽  
Author(s):  
Ao Liu ◽  
Xiao Suna ◽  
Jin Xu ◽  
Yunpeng Xuan ◽  
Feng Hou ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Tumor Spread ◽  
Spread Through Air Spaces

Significance of Spread Through Air Spaces in Resected Pathological Stage I Lung Adenocarcinoma

2018 ◽  
Vol 105 (6) ◽  
pp. 1655-1663 ◽  
Author(s):  
Gouji Toyokawa ◽  
Yuichi Yamada ◽  
Tetsuzo Tagawa ◽  
Yuka Kozuma ◽  
Taichi Matsubara ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Stage I ◽  
Pathological Stage ◽  
Spread Through Air Spaces

scholarly journals Histopathologic Features From Preoperative Biopsies to Predict Spread Through Air Spaces in Early Stage Lung Adenocarcinoma: A Retrospective Study

2021 ◽  
Author(s):  
Lanqing Cao ◽  
Meng Jia ◽  
Ping-Li Sun ◽  
Hongwen Gao
Keyword(s):  
Lung Adenocarcinoma ◽  
Early Stage ◽  
Histologic Subtype ◽  
Necrotic Tumor ◽  
N Stage ◽  
Grade 3 ◽  
Study Participants ◽  
Surgical Extent ◽  
Histopathologic Features ◽  
Spread Through Air Spaces

Abstract Background: Although spread through air spaces (STAS) is a robust biomarker in surgically resected lung cancer, its application to biopsies is challenging. Moreover, limited resection is not an effective treatment for STAS-positive lung adenocarcinoma. This study aimed to identify histologic features from preoperative percutaneous transthoracic needle biopsies (PTNBs) to predict STAS status in the subsequently resected specimens, and thus help in selecting the surgical extent.Methods: Between January 2014 and December 2015, 111 PTNB specimens and subsequent resection specimens from consecutive lung adenocarcinoma patients were retrospectively examined. Histopathologic features of PTNB specimens and presence of STAS in subsequent resection specimens were evaluated and correlations between them were analyzed statistically.Results: The study participants had a mean age of 59 years (range, 35–81) and included 50 men and 61 women. Thirty-six patients were positive for STAS whereas 75 were negative. The micropapillary/solid histologic subtypes of lung adenocarcinoma (26 of 39; 66.7%; P < 0.001), necrotic/tumor debris (31 of 42; 73.8%; P < 0.001), intratumoral budding (ITB) (20 of 33; 60.6%; P < 0.001), desmoplasia (35 of 41; 85.4%; P < 0.001), and grade 3 nuclei (12 of 14; 85.7%; P < 0.001) were more common in STAS-positive tumors. Micropapillary/solid histologic subtype (OR, 1.35; 95% CI: 1.06, 1.67), ITB (OR, 1.64; 95% CI: 1.09, 2.83), desmoplasia (OR, 1.83; 95% CI: 1.36, 3.12), and N stage (N1 stage: OR, 1.37; 95% CI: 1.19, 1.87) (N2 stage: OR, 1.29; 95% CI: 1.07, 1.73) were independent predictors of STAS. Conclusions: Micropapillary/solid histologic subtype, ITB, and desmoplasia in preoperative PTNB specimens were independently associated with STAS in the subsequent resection specimens. Therefore, these can predict STAS and may help to optimize therapeutic planning.

scholarly journals Relationship between stromal cells and tumor spread through air spaces in lung adenocarcinoma

2019 ◽  
Vol 10 (2) ◽  
pp. 256-267 ◽  
Author(s):  
Xie Qiu ◽  
Donglai Chen ◽  
Yangyang Liu ◽  
Shanzhou Duan ◽  
Fuquan Zhang ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Stromal Cells ◽  
Tumor Spread ◽  
Spread Through Air Spaces

scholarly journals Relevance and prognostic ability of Twist, Slug and tumor spread through air spaces in lung adenocarcinoma

2020 ◽  
Vol 9 (6) ◽  
pp. 1986-1998 ◽  
Author(s):  
Ao Liu ◽  
Xiao Sun ◽  
Jin Xu ◽  
Yunpeng Xuan ◽  
Yandong Zhao ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Tumor Spread ◽  
Spread Through Air Spaces

scholarly journals Meta-analysis of association between CT-based features and tumor spread through air spaces in lung adenocarcinoma

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Qifan Yin ◽  
Huien Wang ◽  
Hongshang Cui ◽  
Wenhao Wang ◽  
Guang Yang ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Tumor Size ◽  
Large Scale ◽  
Meta Analysis ◽  
Systematic Research ◽  
Ct Image ◽  
Significant Independent Predictor ◽  
Tumor Spread ◽  
Solid Nodule ◽  
Spread Through Air Spaces

Abstract Objective Spread through air space (STAS) is a novel invasive pattern of lung adenocarcinoma and is also a risk factor for recurrence and worse prognosis of lung adenocarcinoma after sublobar resection. The aims of this study are to evaluate the association between computed tomography (CT)-based features and STAS for preoperative prediction of STAS in lung adenocarcinoma, eventually, which could help us choose appropriate surgical type. Methods Systematic research was conducted to search for studies published before September 1, 2019. The association between CT-based features of radiological tumor size>2 cm、pure solid nodule、 part-solid nodule or Percentage of solid component (PSC)>50% and STAS was evaluated. According to rigorous inclusion and exclusion criteria. Eight studies including 2385 patients published between 2015 and 2018 were finally enrolled in our meta-analysis. Results Our results clearly depicted that there is no significant relationship between radiological tumor size>2 cm and STAS with the combined OR of 1.47(95% CI:0.86–2.51). Meta-analysis of 3 studies showed that pure solid nodule in CT image were more likely to spread through air spaces with pooled OR of 3.10(95%CI2.17–4.43). Meta-analysis of 5 studies revealed the part-solid nodule in CT image may be more likely to appear STAS in adenocarcinoma (ADC) (combined OR:3.10,95%CI:2.17–4.43). PSC>50% in CT image was a significant independent predictor in the diagnosis of STAS in ADC from our meta-analysis with combined OR of 2.95(95%CI:1.88–4.63). Conclusion In conclusion, The CT-based features of pure solid nodule、part-solid nodule、PSC>50% are promising imaging biomarkers for predicting STAS in ADC and may substantially influence the choice of surgical type. In future, more studies with well-designed and large-scale are needed to confirm the conclusion.

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