Evidence map›Paper›PMID 42832143›Full record

ArticleAnnals of surgical oncology2026

A Novel Tumor Burden Index to Predict the Prognosis in Stage IA Lung Adenocarcinoma.

Shangshang Ma, Xichun Qin, Xinjie Xia, Yongfei Fan, Rangrang Wang, Xuefeng Ai, Mingjun Li, Leilei Wu, Dong Xie

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Article in Annals of surgical oncology, 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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5 · Who and what money

Authors and funding

9 authors.

Shangshang Ma *Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Xichun Qin *Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Xinjie Xia *Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Yongfei FanDepartment of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Rangrang WangDepartment of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Xuefeng AiDepartment of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Mingjun LiDepartment of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Leilei WuDepartment of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
Dong XieDepartment of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. xiedong@tongji.edu.cn.ORCID http://orcid.org/0000-0002-3715-1801

Funding

China Postdoctoral Science Foundation 2025M782293National Science Foundation of China 82272943Shanghai Municipal Science and Technology Commission 21Y11913400Zhejiang Provincial Medical Health Science and Technology Project 2025KY695
6 · The paper itself

Abstract

backgroundThis study aimed to evaluate the prognostic utility of a novel tumor burden index (TBI) for patients with pathologic stage IA lung adenocarcinoma after complete resection.

methodsThis study retrospectively analyzed 994 patients with stage IA lung adenocarcinoma who underwent preoperative chest computed tomography (CT) and curative resection. The TBI was derived from radiologic evaluation. Survival outcomes were assessed using Kaplan-Meier estimates and Cox proportional hazards models.

resultsDuring a median follow-up period of 60.6 months, 13.6% of the patients experienced recurrence. Multivariable analysis identified TBI, predominant histologic subtype, surgery extent, spread through air spaces (STAS), and consolidation-to-tumor ratio (CTR) as independent predictors of recurrence-free survival (RFS). Optimal TBI cutoffs of 1.6 and 8.0 stratified patients into three distinct prognostic groups with significantly different RFS and overall survival rates. The TBI demonstrated superior prognostic discrimination compared with tumor diameter or volume. Subgroup analysis showed that for patients with low TBI, sublobar resection achieved RFS comparable with lobectomy, whereas anatomic resection provided outcomes superior to those of wedge resection in the intermediate- and high-TBI groups (segmentectomy vs. wedge resection: hazard ratio [HR], 0.36; 95% confidence interval [CI], 0.14-0.89; P = 0.027; lobectomy vs. wedge resection: HR, 0.34; 95% CI 0.17-0.67; P = 0.002).

conclusionsThe novel TBI is a robust prognostic marker in stage IA lung adenocarcinoma and may inform personalized surgical strategy based on individualized risk assessment.

Indexed as

Lung adenocarcinomaPrognosisTumor burdenTumor volume

Identifiers

PMID42832143

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