ArticleJournal of thoracic disease2023
Prognostic significance of limited resection in pathologic stage I lung adenocarcinoma with spread through air spaces.
Article in Journal of thoracic disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 6 citations in OpenAlex.
- Nomogram based on computed tomography fractal dimension for predicting spread through air spaces in lung adenocarcinoma.Frontiers in medicine · 2026Article
- Feature-interactive Siamese graph encoder-based image analysis to predict STAS from histopathology images in lung cancer.NPJ precision oncology · 2024Article
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Authors and funding
7 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Tumor spread through air spaces (STAS) is now recognized as tumor invasion. However, the association between STAS and procedure-specific outcomes (limited resection and lobectomy) in patients with pathologic stage I lung adenocarcinoma (ADC) is still under investigation. Methods: To investigate whether limited resection predicts poorer survival in such patients, we retrospectively analyzed the clinicopathologic features of a large cohort of 1,566 patients with stage I ADC from 2017 to 2020 and classified them according to STAS status and surgical method. Kaplan-Meier, Cox hazard proportional regression, and propensity score matching (PSM) were adopted for prognostic evaluation. Results: STAS-positive patients had worse recurrence-free survival (RFS) (P<0.001). There was no significant difference in RFS and overall survival (OS) between limited resection and lobectomy, neither for the STAS-negative nor STAS-positive group before matching. After matching, limited resection was found to achieve comparable RFS to lobectomy in STAS-positive patients with pathologic I, IA, or IB stage tumor, (P=0.816, P=0.576, P=0.281, respectively), but worse OS in stage I and stage IB patients (P=0.029, P=0.010, respectively). Furthermore, in multivariable analysis, limited resection was not an independent prognostic factor of RFS or OS. Instead, the high-grade histological subtype was the only independent prognostic factor for RFS (P=0.001). In the subgroup analysis, adjuvant chemotherapy (ACT) did not improve the outcomes of stage IB STAS-positive patients. Conclusions: Limited resection was associated with worse survival than lobectomy in stage I STAS-positive patients, but not in stage IA STAS-positive patients.
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