ArticleThoracic cancer2025
Risk Stratification and Adjuvant Chemotherapy for High-Risk Stage IA Lung Adenocarcinoma: The Unmet Needs.
Article in Thoracic cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Deep learning for Three-Class Classification of ground-glass nodules on non-enhanced chest CT: A multicenter comparative study of CNN architectures.European journal of radiology open · 2025Article
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8 authors.
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Abstract
introductionTo identify high-risk patients for recurrence in resected stage IA lung adenocarcinoma and evaluate the impact of adjuvant chemotherapy (ACT) on their prognosis, as well as explore potential novel adjuvant therapies.
methodsConsecutive stage IA patients with ≥ 5% solid or micropapillary subtypes were analyzed. A nomogram was developed using Cox proportional hazards regression to predict recurrence-free survival (RFS). In the high-risk group after stratification, RFS was compared between patients receiving ACT and those under observation, as well as between patients with and without driver gene alterations.
resultsThis real-world study included 1328 patients, with a 5-year RFS of 79.0%. T stage and predominant subtype were independent risk factors for RFS. Patients with T1c or solid/micropapillary-predominant tumors were stratified into a high-risk group (n = 483) using the nomogram. A significant difference in 5-year RFS was observed between the high- and low-risk groups (73.6% vs. 84.3%, p < 0.001). Among high-risk patients, sixty-seven (13.8%) received ACT; however, there was no improvement in 5-year RFS compared to observation alone (69.1% vs. 75.0%, p = 0.655). Testing rates for EGFR mutation and ALK fusion among high-risk patients were only 52.4% and 43.9%, respectively, while mutation rates reached up to 55.7% and 9.4%, respectively. These molecular alterations exhibited numerically worse 5-year RFS compared to wild-type (EGFR mutation, 70.6% vs. 87.8%, p = 0.108; ALK fusion, 66.3% vs. 73.6%, p = 0.404), though not significant.
conclusionsACT failed to meet the needs of stage IA patients with histological high-risk features. Further exploration of effective adjuvant target therapies is warranted for this patient subgroup.
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