ArticleTranslational lung cancer research2026
Lepidic pattern as a favorable prognostic factor in pathologically high-risk stage I invasive lung adenocarcinoma.
Article in Translational lung cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The prognostic value of lepidic pattern in small stage I lung adenocarcinoma (LUAD) with pathological high-risk features remains unclear. This study evaluated whether lepidic pattern was associated with improved survival outcomes in this pathologically high-risk population. Methods: Consecutive patients with surgically resected stage I invasive LUAD measuring ≤3 cm at West China Hospital, Sichuan University, between January 2018 and April 2025 were retrospectively reviewed. Patients with at least one pathological high-risk feature were included and stratified according to the presence or absence of lepidic pattern. Recurrence-free survival (RFS) and overall survival (OS) were compared before and after propensity score matching. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: A total of 1,233 patients were included, including 412 without lepidic pattern and 821 with lepidic pattern. After 1:1 propensity score matching, 315 matched pairs were generated. The median follow-up duration was 44 months. In the overall cohort, patients with lepidic pattern had better RFS than those without lepidic pattern, with 3-year RFS rates of 96.8% and 87.0%, respectively, and estimated 5-year RFS rates of 94.0% and 81.9%, respectively (HR, 0.42; 95% CI: 0.25-0.70; P<0.001). This association persisted after matching, with 3-year RFS rates of 96.3% and 86.6%, respectively, and estimated 5-year RFS rates of 92.2% and 81.2%, respectively (HR, 0.37; 95% CI: 0.20-0.69; P=0.001). In multivariable analysis, lepidic pattern remained independently associated with improved RFS (adjusted HR, 0.42; 95% CI: 0.25-0.70; P=0.001). OS was not significantly associated with lepidic pattern after matching or multivariable adjustment. Conclusions: Lepidic pattern was independently associated with improved RFS, but not OS, in patients with pathologically high-risk small stage I LUAD. Lepidic pattern may serve as a complementary histologic marker for postoperative recurrence risk stratification.
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