ArticleTranslational lung cancer research2021
Predictors of upstage and treatment strategies for stage IA lung cancers after sublobar resection for adenocarcinoma in situ and minimally invasive adenocarcinoma.
Article in Translational lung cancer research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 12 citations in OpenAlex.
- Predictive value of artificial intelligence-based quantitative CT feature analysis for diagnosing the pathological types of pulmonary nodules.European radiology · 2026Article
- A nomogram for predicting invasiveness of lung adenocarcinoma manifesting as ground-glass nodules based on follow-up CT imaging.Translational lung cancer research · 2024Article
- Development and validation of a model for predicting upstage in minimally invasive lung adenocarcinoma in Chinese people.World journal of surgical oncology · 2024Article
- CT imaging features of lung ground-glass nodule patients with upgraded intraoperative frozen pathology.Discover oncology · 2024Article
- Circulomic variables predict pathologic staging preoperatively in treatment-naïve non-small cell lung cancer.Journal of thoracic disease · 2023Article
- Preoperative levels of folate receptor-positive circulating tumor cells in different subtypes of early-stage lung adenocarcinoma: Predictive value for determining extent of surgical resection.Frontiers in oncology · 2023Article
- Is it time to revise the International Association for the Study of Lung Cancer definitions of completeness of lung cancer resection?Translational cancer research · 2022Article
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10 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundInvasive adenocarcinoma intraoperatively underestimated as adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA) based on frozen section (FS) is more likely to undergo insufficient resection. We aimed to investigate the predictors of upstage and treatment strategies for stage IA invasive adenocarcinoma after sublobar resection for AIS and MIA.
methodsWe identified 2,006 patients from January 2012 to December 2016 with early-stage lung adenocarcinoma who underwent sublobar resection based on FS diagnosis to guide surgical decision-making. All FS were categorized into three groups in real-time: (I) atypical adenomatous hyperplasia (AAH), (II) AIS, and (III) MIA.
resultsA total of 272 (13.5%, 272/2,006) cases were upstaged in the final pathology (FP) diagnosis (82 AAH to AIS, 127 AIS to MIA, and nine AIS and 54 MIA to invasive adenocarcinoma), and most upstage cases (64.3%, 175/272) were attributed to sampling error. Multivariate logistic regression showed that tumor size ≥1 cm was the only independent predictor of upstage. The upstage of 209 cases to AIS or MIA had no influence on the therapy because the extent of their resection was enough. Of the 63 cases upstaged to invasive adenocarcinoma, only 13 cases agreed to receive complementary treatment: five patients underwent complementary lobectomy, and seven patients received chemotherapy. Two invasive adenocarcinoma cases without complementary treatment experienced a local recurrence after surgery. No recurrence was observed in AAH, AIS and MIA. No patient died until December 01, 2019.
conclusionsTimely complementary treatment is encouraged in AIS/MIA upstaged to invasive adenocarcinoma based on the FP after sublobar resection to avoid local recurrence. Pathologists should be more cautious about AIS and MIA with tumor size ≥1 cm to avoid underestimation and potentially insufficient resection.
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