Impact of High-Grade Patterns in Early-Stage Lung Adenocarcinoma: A Multicentric Analysis

Objective The presence of micropapillary and solid adenocarcinoma patterns leads to a worse survival and a significantly higher tendency to recur. This study aims to assess the impact of pT descriptor combined with the presence of high-grade components on long-term outcomes in early-stage lung adeno...

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Detalles Bibliográficos
Autores: Bertoglio, P. (Pietro)|||/items/b90005ec-be9b-47e6-ad95-6619e0d9e473, Aprile, V. (Vittorio)|||/items/1d8ac770-143d-4c82-9c1e-aeb8ac963de6, Ventura, L. (Luigi)|||/items/d8224959-7273-4d2f-80dc-f55155bc189d, Cattoni, M. A. (Maria Angela)|||/items/a43ceb17-8643-408b-ab87-658b381a4d99, Nachira, D. (Dania)|||/items/0ebb23dc-5e0d-4503-8bf0-ddfe816dcd32, Lococo, F. (Filippo)|||/items/4ff53018-4815-44fb-a5df-58553f34dae4, Rodríguez-Pérez, M.C. (María C.)|||/items/e7a4053b-ce80-4e0b-b37b-afbe3a88081b, Guerrera, F. (Francesco)|||/items/b5d80521-058e-49c5-b3c9-0428c347e61c, Minervini, F. (Fabrizio)|||/items/1f4b9a59-f88d-4538-811d-9dd91958d7aa, Querzoli, G. (Giulia)|||/items/8d87b626-34d4-4409-955a-f8fb47a2391d, Bocchialini, G. (Giovanni)|||/items/4df9d01d-602c-44c5-bb9a-8a0c4ac0a52f, Bacchin, D. (Diana)|||/items/67c8a3a7-f959-4ce8-8f95-61bb69a710c2, Franzi, F. (Francesca)|||/items/08d83ab2-67fb-4675-a205-5ca4772dbaca, Rindi, G. (Guido)|||/items/808984a6-522a-462c-98ff-771496a8423d, Bellafiore, S. (Salvatore)|||/items/ace51046-3cfd-4db4-be24-0086645cc3a3, Femia, F. (Federico)|||/items/88fa615c-4f74-482e-a4fa-d8d2a4407545, Bogina, G. S. (Giuseppe Salvatore)|||/items/b4655173-7aec-4ab7-9061-e482dd896d7e, Solli, P. (Piergiorgio)|||/items/88cd4f33-e0d6-407c-9782-93223c69bcfc, Kestenholz, P. (Peter)|||/items/155ca518-725c-412f-b346-df90e21f3490, Ruffini, E. (Enrico)|||/items/8ebb0402-6c3b-46ff-a4b8-a2fd769af183, Paci, M. (Massimiliano)|||/items/b6754c62-e6f8-4b61-bae2-f8ba3325331e, Margaritora, S. (Stefano)|||/items/8f8e1ea3-9908-4b7e-ad73-8e6a0dce9404, Imperatori, A. S. (Andrea Selenito)|||/items/bad4fe3f-c4ce-4925-9db9-56940cd06e4a, Lucchi, M. (Marco)|||/items/a44085b7-539a-4d8e-82f5-6cf90e849f67, Gnetti, L. (Letizia)|||/items/793adbd6-c953-4569-8735-696ada2826b7, Terzi, A. C. (Alberto Claudio)|||/items/4199c332-289c-40c1-8a0a-f9015d426535
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/69026
Acceso en línea:https://hdl.handle.net/10171/69026
Access Level:acceso abierto
Palabra clave:Lung adenocarcinoma
TNM staging
Lung cancer
Adenocarcinoma subtype
Descripción
Sumario:Objective The presence of micropapillary and solid adenocarcinoma patterns leads to a worse survival and a significantly higher tendency to recur. This study aims to assess the impact of pT descriptor combined with the presence of high-grade components on long-term outcomes in early-stage lung adenocarcinomas. Methods We retrospectively collected data of consecutive resected pT1-T3N0 lung adenocarcinoma from nine European Thoracic Centers. All patients who underwent a radical resection with lymph-node dissection between 2014 and 2017 were included. Differences in Overall Survival (OS) and Disease-Free Survival (DFS) and possible prognostic factors associated with outcomes were evaluated also after performing a propensity score matching to compare tumors containing non-high-grade and high-grade patterns. Results Among 607 patients, the majority were male and received a lobectomy. At least one high-grade histological pattern was seen in 230 cases (37.9%), of which 169 solid and 75 micropapillary. T1a-b-c without high-grade pattern had a significant better prognosis compared to T1a-b-c with high-grade pattern (p = 0.020), but the latter had similar OS compared to T2a (p = 0.277). Concurrently, T1a-b-c without micropapillary or solid patterns had a significantly better DFS compared to those with high-grade patterns (p = 0.034), and it was similar to T2a (p = 0.839). Multivariable analysis confirms the role of T descriptor according to high-grade pattern both for OS (p = 0.024; HR 1.285 95% CI 1.033–1.599) and DFS (p = 0.003; HR 1.196, 95% CI 1.054–1.344, respectively). These results were confirmed after the propensity score matching analysis. Conclusions pT1 lung adenocarcinomas with a high-grade component have similar prognosis of pT2a tumors.

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