Author of

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  P1.05 - Interventional Diagnostics/Pulmonology (Not CME Accredited Session) (ID 937)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

  • 26482

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    P1.05-08 - Spread Through Air Spaces (STAS) in Invasive Mucinous Adenocarcinoma of the Lung: Incidence, Prognostic Impact, and Predictive Factors (ID 13767)

    16:45 - 18:00  |  Presenting Author(s): Min A Lee
    • Abstract
    • Slides

    Background
    

    Spread through air spaces (STAS) is a recently recognized as a novel negative impact on prognosis in lung adenocarcinoma, however was almost investigated non-mucinous adenocarcinoma. We investigated the incidence of STAS in invasive mucinous adenocarcinoma (IMA) of the lung and whether tumor STAS was a risk factor of disease recurrence even in IMA, and determined clinico-radiologic factors in patients with IMA harboring STAS.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We reviewed pathologic specimens and imaging characteristics of primary tumors from 132 consecutive patients who underwent surgical resection for IMA. On pathology, the presence of aerogenous spread (AS), mucin, and STAS were evaluated. Two groups determined by STAS were compared with respect to clinical characteristics as well as CT imaging using the Pearson χ2 test or the Fisher exact test. Multivariate logistic regression was used to explore the clinico-radiologic features that facilitate the detection of STAS in IMA, for which receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance. The relationships between all variables including STAS and survival (overall survival [OS] and disease-free survival [DFS]) were analyzed by using Kaplan–Meier curves and Cox regression analyses.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Of 119 patients with full pathologic specimens, STAS was observed in 86 patients (72.3%). On multivariate analysis, IMA patients with STAS were significantly tended to be lobectomy (odds ratio [OR] = 7.120, 95% confidence interval [CI] = 1.184 to 42.825, P value = 0.032), older (OR = 2.979, 95% CI = 1.109 to 8.001, P value = 0.030) and the absence of peripheral GGO on CT (OR =0.376, CI=0.141 to 0.999 , P value = 0.049), where the predictive model for presence of STAS showed discrimination performance with an area under the receiver operating characteristic curve (AUC) of 0.798 (95% CI = 0.711 to 0.884, P value < 0.005). The DFS was lower in patients with STAS compared with in those without STAS, whereas there was no statistically significant difference (P value =0.091). On multivariate analysis for DFS, STAS failed to be an independent predictor, but lymph node metastasis (hazard ratio [HR], 2.505; 95% CI 1.288–11.089, absence of mucin on pathologic specimen (HR, 0.46; 95% CI 0.194–0.985) and CT angiogram sign (HR, 2.872; 95% CI 1.036–7.963) remained independent predictors for disease recurrence.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    IMA with STAS represented older age, absence of peripheral GGO on CT, more frequent lobectomy than limited resection. STAS was associated with reduced DFS, but failed to be a significant prognostic factor.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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