Analysis of the clinicopathologic characteristics and prognostic of stage I invasive mucinous adenocarcinoma

Luo, Jizhuang; Wang, Rui; Han, Baohui; Zhang, Jie; Zhao, Heng; Fang, Wentao; Luo, Qingquan; Yang, Jun; Yang, Yunhai; Zhu, Lei; Chen, Tianxiang; Cheng, Xinghua; Wang, Yiyang; Zheng, Jie; Chen, Haiquan

doi:10.1007/s00432-016-2201-9

Cited by 23 publications

(20 citation statements)

References 26 publications

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“…The postoperative lung cancer surveillance, described in our previous publications [15,16], consisted of physical examination, blood tests, chest computed tomography, neck and upper abdominal ultrasound examination, and were performed every 3 months for the first year after surgery and at 6-month intervals thereafter. Whole-body bone scanning and brain magnetic resonance imaging were performed annually.…”

Section: Surveillance Protocolmentioning

confidence: 99%

Impact of Solid Minor Histologic Subtype in Postsurgical Prognosis of Stage I Lung Adenocarcinoma

Chen

Luo

et al. 2018

The Annals of Thoracic Surgery

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Section: Surveillance Protocolmentioning

confidence: 99%

Impact of Solid Minor Histologic Subtype in Postsurgical Prognosis of Stage I Lung Adenocarcinoma

Chen

Luo

et al. 2018

The Annals of Thoracic Surgery

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“…Positron emission tomography (PET) scans were recommended for patients with suspicious hilum or mediastinal lymph node enlargement. The postsurgical surveillance was performed as previously described (19,20): chest CT and neck and upper abdominal ultrasound examinations were performed every 3 months for the first …”

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confidence: 99%

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

et al. 2018

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Background: This study aimed to evaluate the prognostic difference between limited resection and lobectomy among elderly patients with small size lung adenocarcinoma. Methods: A total of 666 patients >65 years old with stage I lung adenocarcinoma and tumor size ≤2 cm were included. The patient survival was evaluated by disease-free survival (DFS) and overall survival (OS). Results: No DFS or OS advantage was found between the lobectomy and wedge resection groups when tumor sizes were ≤1 cm (DFS, P=0.112; OS, P=0.294). The wedge resection group had a significantly worse OS (P=0.041) than that in the lobectomy group when tumor sizes were >1 cm and ≤2 cm. Conclusions: We conclude that wedge resection may be a reasonable surgical choice for elderly patients with tumor sizes ≤1 cm. The International Association Study of Lung Cancer (IASLC), the American Thoracic Society (ATS) and the European Respiratory Society (ERS) proposed a new edition of the lung adenocarcinoma classification system in 2011 (12). It has been effectively used to predict the prognosis of lung adenocarcinoma patients. The classification was established on the most predominant subtype presented: invasive adenocarcinoma with solid (SOL) or micropapillary (MIP) carcinoma, which is associated with a poor survival (13)(14)(15)(16)(17). Both adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) have nearly 100% postsurgical survival, and limited resection is appropriate for those patients. However, to date, whether limited resection is adequate for early-stage invasive lung adenocarcinoma patients, especially for patients who are older than 65, has not been thoroughly studied (8). In this study, a large cohort investigation was carried out to determine the correlation between surgical procedures and postoperative survival among elderly lung adenocarcinoma patients with tumor sizes ≤2 cm. Our study may help to design personalized surgical strategies for older patients. Methods Patient cohortThe retrospective study was permitted by the Institutional Review Board of Shanghai Chest Hospital at Shanghai Jiao Tong University and was performed in compliance with the guidelines of clinical research [ethic approval ID: KS(P)1802].We retrospectively reviewed patients who underwent surgical resection at our hospital between January 2009 and March 2015. The inclusion criteria were patients 65 years old or older, presentation of a single lung nodule, the postsurgical pathological specimen examination validated that the tumor size was less than or equal to 2 cm, there was no lymph node invasion, and there was no distant organ metastasis. The exclusion criteria included patients who had a history of malignancy, had multiple nodules, received neoadjuvant chemotherapy AIS or MIA. Invasive adenocarcinoma variants (such as mucinous, enteric or fetal morphologies) were also excluded for low incidence. Finally, this study included a total of 666 patients.In our clinical practice, patients with the following characteristics were treated with limited resect...

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“…A wide variety of chemotherapeutic options are available for advanced BAC or IMA (8,9), but with a poor sensitivity rate. According to the results of 30 relevant studies, including 19 case reports and 11 clinical trials on IMA treatment (Table I), IMA exhibits a poor response to traditional chemotherapy, such as paclitaxel (10,11), navebine (12) and platinum-based chemotherapy (13,14), with a median progression-free survival (PFS) ranging from 2.2 to 5 months, and an overall survival (OS) ranging from 13 to 23 months.…”

Section: Discussionmentioning

confidence: 99%

Favorable response to pemetrexed, cisplatin and bevacizumab in invasive mucinous adenocarcinoma: A case report and literature review

et al. 2018

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Invasive mucinous adenocarcinoma (IMA) was formerly referred to as mucinous bronchioloalveolar carcinoma. The lack of effective chemotherapy and comprehensive treatment for this type of tumor poses a great challenge in clinical practice. We herein report the case of a male patient with IMA who was treated with a combination of pemetrexed (500 mg/m), cisplatin (75 mg/m) and bevacizumab (15 mg/kg) as first-line chemotherapy. The patient achieved significant radiological improvement with 6 courses of this regimen. After the tumor progressed, the patient again achieved marked improvement with an additional 4 courses of the same regimen. The patient survived for a total of 30 months after the first chemotherapy. Therefore, bevacizumab in combination with pemetrexed/cisplatin may be an effective strategy for the treatment of IMA. The available literature on this chemotherapy regimen was also reviewed and discussed in the present study.

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Analysis of the clinicopathologic characteristics and prognostic of stage I invasive mucinous adenocarcinoma

Abstract: Mixed mucinous/nonmucinous IMA had a worse DFS compared with pure mucinous. Early stage IMA could not benefit from adjuvant chemotherapy.

Cited by 23 publications

References 26 publications

Impact of Solid Minor Histologic Subtype in Postsurgical Prognosis of Stage I Lung Adenocarcinoma

Impact of Solid Minor Histologic Subtype in Postsurgical Prognosis of Stage I Lung Adenocarcinoma

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

Favorable response to pemetrexed, cisplatin and bevacizumab in invasive mucinous adenocarcinoma: A case report and literature review

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