ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2022
Assessment of the feasibility of frozen sections for the detection of spread through air spaces (STAS) in pulmonary adenocarcinoma.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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37 citing papers in PubMed, 59 citations in OpenAlex.
- Femtosecond label-free imaging: A rapid and reliable alternative for intraoperative pathological assessment in thoracic oncology.JTCVS open · 2026Article
- Machine learning-based preoperative prediction of spread through air spaces in clinical stage IA non-small cell lung cancer: a single-center study integrating clinical and CT imaging characteristics.Journal of thoracic disease · 2026Article
- Predicting STAS in peripheral stage I lung adenocarcinoma: the incremental value of CT-based tumor disappearance rate, with a focus on part-solid nodules.BMC medical imaging · 2026Article
- Optimizing surgical decision-making for lung adenocarcinoma by preoperatively identifying pathological high-risk factors: retrospective development and prospective validation of a deep learning model.International journal of surgery (London, England) · 2026Article
- Diffusion attention expert model for predicting and semi-automatic localizing STAS in lung cancer histopathological images.Nature communications · 2026Article
- STAS More than a Prognostic Marker-An Evolving Factor in Operative and Adjuvant Treatment Decisions in Early-Stage NSCLC.Cancers · 2026Review
- Nomogram based on computed tomography fractal dimension for predicting spread through air spaces in lung adenocarcinoma.Frontiers in medicine · 2026Article
- CT-based intratumoral habitat and peritumoral radiomics model to predict spread through air spaces in solid lung adenocarcinoma with diameter ≤ 2 cm: a dual-center study.Frontiers in oncology · 2026Article
- Prognostic Value of STAS, Lymph Node Metastasis, and VPI in NSCLC ≤ 4 cm Treated with Lobectomy.Journal of clinical medicine · 2025Article
- Article
- Development and internal validation of predictive models for spread through air spaces in clinical stage IA lung adenocarcinoma.General thoracic and cardiovascular surgery · 2025Article
- Multidisciplinary Perspective of Spread Through Air Spaces in Lung Cancer: A Narrative Review.Cancers · 2025Review
- Article
- CT-based intratumoral and peritumoral radiomics nomogram to predict spread through air spaces in lung adenocarcinoma with diameter ≤ 3 cm: A multicenter study.European journal of radiology open · 2025Article
- Review
- A narrative review of preoperative CT for predicting spread through air spaces of lung cancer.Translational lung cancer research · 2025Review
- Deep learning model for predicting spread through air spaces of lung adenocarcinoma based on transfer learning mechanism.Translational lung cancer research · 2025Article
- Nomogram model for the preoperative prediction of spread through air spaces in sub-centimeter non-small cell lung cancer.Journal of cardiothoracic surgery · 2025Article
- STAS: New explorations and challenges for thoracic surgeons.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
- Prediction of tumor spread through air spaces with an automatic segmentation deep learning model in peripheral stage I lung adenocarcinoma.Respiratory research · 2025Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
Spread through air spaces (STAS) is reportedly associated with worse prognosis in sublobar resections of lung adenocarcinoma. Recently, it was proposed that STAS detected on frozen sections can be an indication for lobectomy instead of sublobar resection. We undertook this study to evaluate the reliability of STAS assessment on frozen sections compared to permanent sections, as well as the associations among STAS, tumor grade, and recurrence-free survival (RFS) after sublobar resection. A total of 163 stage I lung adenocarcinoma resections with frozen sections were identified retrospectively. For each case, and for frozen and permanent sections separately, the presence or absence of STAS, as well as the tumor grade, were recorded. Compared to permanent sections, STAS detection on frozen sections had low sensitivity (55%), low positive predictive value (48%), and fair agreement (K = 0.34), whereas there was higher specificity (80%) and negative predictive value (85%). Accuracy was 74%. Tumor grade assessment on frozen sections showed higher sensitivity (77%), positive predictive value (90%), agreement (K = 0.72), specificity (94%), and accuracy (87%), and the same negative predictive value (85%). High-grade histology on frozen sections was associated with shorter RFS (p = 0.02), whereas STAS on frozen sections was not (p = 0.47). Our results suggest that the intraoperative detection of STAS has low sensitivity and positive predictive value. False-positive results may lead to overtreatment of patients with lung cancer. The determination of tumor grade on frozen sections offers better sensitivity and specificity, plus it is associated with RFS, whereas STAS on frozen sections is not. Further study is needed to explore the utility of assessing tumor grade on frozen sections.
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