Complete Lymphadenectomy for Clinical Stage I Lepidic Adenocarcinoma of the Lung: Is it justified?

Maurizi, Giulio; D’Andrilli, Antonio; Argento, Giacomo; Ciccone, Anna Maria; Ibrahim, Mohsen; Andreetti, Claudio; Vanni, Camilla; Tierno, Simone Maria; Venuta, Federico; Rendina, Erino Angelo

doi:10.1053/j.semtcvs.2021.11.020

Cited by 2 publications

(6 citation statements)

References 23 publications

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“…This suggests that lepidic adenocarcinomas have a more favorable prognosis in terms of both overall and disease-free survival. These data are in line with the published experiences that include patients undergoing surgery for this peculiar lung cancer [12,20]. These findings have implications for the clinical management of patients with GGOs.…”

Section: Discussionsupporting

confidence: 88%

“…GGO lesions have been reported to have a good prognosis [15], and in most cases, their pathological features are minimally invasive [12]. According to Fu et al, the 5-year recurrence-free survival (RFS) rates for patients with pure GGO, part-solid, and solid nodules in invasive stage I non-small cell lung cancer (NSCLC) were documented at 100%, 87.6%, and 73.2%, respectively [15].…”

Section: Discussionmentioning

confidence: 99%

“…According to Fu et al, the 5-year recurrence-free survival (RFS) rates for patients with pure GGO, part-solid, and solid nodules in invasive stage I non-small cell lung cancer (NSCLC) were documented at 100%, 87.6%, and 73.2%, respectively [15]. Many previous studies have focused on the radiological and histological correlations between pure GGO and the lepidic component or mixed GGO and the non-predominant-Lepidic component (with >60% of lepidic component) to identify subjects at risk of recurrence or lymph node involvement as soon as possible [5,6,12].…”

Section: Discussionmentioning

confidence: 99%

“…This study confirmed, as other studies have already done, the importance of performing a correct lymphadenectomy in lepidic forms of adenocarcinoma, which, although less aggressive, can still result in recurrence and the need for adjuvant therapy. Plenty of studies [18] have demonstrated the superiority of radical lymph node dissection over lymph node sampling to guarantee better long-term survival and lower recurrence rates [10,12]. Many studies have confirmed that lymphadenectomy sampling can be considered optimal in patients with GGO [21,22].…”

Section: Discussionmentioning

confidence: 99%

“…The correlation between the presence of ground glass opacities (GGOs) and favorable survival outcomes in lung adenocarcinoma is widely acknowledged. Moreover, Invasive adenocarcinomas with a predominantly lepidic component have a better prognosis than adenocarcinomas with other patterns [11,12]. Surgical resection is the first treatment option for GGO-featured lung adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Factors of Non-Predominant-Lepidic Lung Adenocarcinoma Presenting as Ground Glass Opacity: Results of a Multicenter Study

Messa,

Siciliani,

Piccioni

et al. 2024

JPM

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This study aims to define the clinicopathological characteristics and prognosis of non-predominant lepidic invasive adenocarcinoma presenting as Ground Glass Opacity (GGO) nodules. The goal is to assess statistical relationships between histology, tumor size, location, and the incidence of relapse and lymph node dissemination. A retrospective multicenter study was conducted, including patients with GGO observed on CT scans between 2003 and 2021. Anamnestic, radiological, and histological data, as well as SUV values, lymphatic and vascular invasion, pathological stage, resection type, and adjuvant treatment, were analyzed. The primary endpoints were to evaluate prognostic factors for death and recurrence using Cox regression analysis. All 388 patients, including 277 with non-predominant lepidic invasive adenocarcinoma and 161 with lepidic adenocarcinoma, underwent curative anatomical resection. Non-predominant lepidic invasive adenocarcinoma demonstrated a worse prognosis than lepidic adenocarcinoma (p = 0.001). Independent prognostic factors for death and recurrence included lymph node involvement (p = 0.002) and vascular and lymphatic invasion (p < 0.001). In conclusion, non-predominant lepidic invasive adenocarcinoma and lymphatic and vascular invasion are prognostic factors for death and recurrence in GGO patients. Results suggest adjuvant treatment in the case of pN1-N2 disease, emphasizing the necessity of lymphadenectomy (sampling or systematic) for accurate staging and subsequent therapeutic procedures.

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Section: Discussionsupporting

confidence: 88%