ArticleWorld journal of surgical oncology2025
Prognostic significance of tumor spread through air spaces and lymphovascular invasion in stage I non-small cell lung cancer: implications for adjuvant chemotherapy.
Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Prognostic Impact of Lymphovascular Invasion in Resected Pathological Stage I Invasive Non-small Cell Lung Cancer: A Propensity Score-Matched Cohort Study.Annals of surgical oncology · 2026Article
- Spread through air spaces as an independent prognostic factor in resected lung adenocarcinoma: the role of resection type.World journal of surgical oncology · 2026Article
- Adjuvant chemotherapy for completely resected stage IB-IIA non-small cell lung cancer according to the AJCC 8th edition staging system: a real-world retrospective cohort study based on the SEER database.Translational lung cancer research · 2026Article
- Prognostic Value of STAS, Lymph Node Metastasis, and VPI in NSCLC ≤ 4 cm Treated with Lobectomy.Journal of clinical medicine · 2025Article
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13 authors.
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Abstract
objectiveTumor spread through air spaces (STAS) and lymphovascular invasion (LVI) have been associated with poor prognosis in stage I non-small cell lung cancer (NSCLC). This study aimed to evaluate the prognostic significance of STAS and LVI, and to investigate the impact of adjuvant chemotherapy (ACT) on survival outcomes in this patient population.
methodsA retrospective cohort study was conducted including 392 patients with pathological stage I NSCLC who underwent surgical resection at two Kaohsiung Medical University-affiliated hospitals between 2016 and 2019. Patients were stratified into three groups: STAS-positive without LVI (STAS + LVI-), STAS-positive with LVI (STAS + LVI+), and STAS-negative (STAS-). Survival outcomes were analyzed using Kaplan-Meier methods and Cox proportional hazards models. Associations between tumor size, STAS, and LVI were evaluated using chi-square tests.
resultsSTAS was identified in 101 patients (25.8%), of whom 20 (19.8%) also exhibited LVI. The prevalence of both STAS and LVI increased significantly with tumor size (p < 0.0001 for both). STAS positivity was independently associated with inferior recurrence-free survival (RFS) (hazard ratio [HR] = 2.33, p = 0.021). Overall, ACT did not significantly improve survival in STAS-positive patients (p = 0.63). However, among patients with concurrent STAS and LVI, a trend toward improved 5-year RFS was observed with ACT (54.5% vs. 44.4%; p = 0.43). In contrast, ACT was associated with significantly worse RFS in STAS-negative patients (p = 0.024).
conclusionsSTAS represents an independent adverse prognostic factor in stage I NSCLC, and conventional ACT appears to offer limited benefit in this group overall. Patients harboring both STAS and LVI may derive potential benefit from ACT, whereas STAS-negative patients may require careful evaluation to avoid overtreatment. These findings support the need for personalized, risk-adapted postoperative management strategies and warrant further prospective investigation.
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