Does the presence of a micropapillary component predict worse prognosis in pathological stage IA lung adenocarcinoma?

Wang, Yan; Song, Wen-Peng; Wang, Xin; Che, Guowei

doi:10.1016/j.prp.2023.154314

Cited by 2 publications

(4 citation statements)

References 33 publications

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“…The aggressive patterns of adenocarcinoma represented by the micropapillary and solid subtypes, which were observed in at least 30% of the patients, were more likely to conceal unexpected nodal metastasis in early-stage clinical I NSCLC. These findings are consistent with previous studies that have demonstrated the prognostic role of adenocarcinoma subtypes in the early-stage setting (10). The association of specific subtypes with nodal metastasis could be relevant in guiding the decision for a more extensive resection or in assessing the need for adjuvant treatment (11).…”

Section: Discussionsupporting

confidence: 91%

Analysis of predictive factors of unforeseen nodal metastases in resected clinical stage I NSCLC

Gallina,

Marinelli,

Tajè

et al. 2023

Front. Oncol.

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BackgroundDespite notable advances made in preoperative staging, unexpected nodal metastases after surgery are still significantly detected. In this study we aim to analyze the upstaging rate in patients with clinical stage I NSCLC without evidence of nodal disease in the preoperative staging who underwent lobectomy and radical lymphadenectomy.MethodsPatients who underwent lobectomy and systematic lymphadenectomy for clinical stage I NSCLC were evaluated. Exclusion criteria included the neoadjuvant treatment, incomplete resection and no adherence to preoperative guidelines.ResultsA total of 297 patients were included in the study. 159 patients were female, and the median age was 68 (61 - 73). The variables that showed a significant correlation with the upstaging rate at the univariate analysis were the number of resected lymph nodes and micropapillar/solid adenocar-cinoma subtype. This result was confirmed in the multivariate analysis with a OR= 2.545 (95%CI 1.136-5.701; p=0.02) for the number of resected lymph nodes and a OR=2.717 (95%CI 1.256-5.875; p=0.01) for the high-grade pattern of adenocarcinoma.ConclusionOur results showed that in a homogeneous cohort of patients with clinical stage I NSCLC, the number of resected lymph nodes and the histological subtype of adenocarcinoma can significantly be associated with nodal metastasis.

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Section: Discussionsupporting

confidence: 91%

Analysis of predictive factors of unforeseen nodal metastases in resected clinical stage I NSCLC

Gallina,

Marinelli,

Tajè

et al. 2023

Front. Oncol.

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“…In clinical practice, the MPNP pattern is more common than MPP, especially in the early stages. A meta-analysis indicated that the presence of a micropapillary component in stage IA LUAD, regardless of the level, was associated with an increased risk of recurrence [ 10 ]. The prognostic significance of ACT for patients with stage IA MPNP-LUAD remains unknown until today.…”

Section: Discussionmentioning

confidence: 99%

“…The micropapillary pattern is distinguished by the growth of tumor cells in papillary tufts that do not possess fibrovascular cores [ 6 ]. It has been reported that LUAD with micropapillary components is associated with an increased risk of lymph node metastasis and a more unfavorable prognosis, even in the early stages of the disease [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…In fact, the prevalence of the micropapillary non-predominant (MPNP) pattern (also known as micropapillary minor pattern) is more common than that of MPP adenocarcinoma, especially in stage IA LUAD [ 17 ]. A recently published meta-analysis indicated that the presence of a micropapillary component in stage IA LUAD was correlated with an increased risk of recurrence [ 10 ]. However, the potential survival benefits of ACT for patients with stage IA MPNP-LUAD have not been studied to date.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic significance and survival benefits of postoperative adjuvant chemotherapy in patients with stage IA lung adenocarcinoma with non-predominant micropapillary components

Li,

Qiu,

et al. 2024

World J Surg Onc

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Background The prognostic significance of adjuvant chemotherapy (ACT) for patients with stage IA micropapillary non-predominant (MPNP) lung adenocarcinoma (LUAD) remains unknown. This study aimed to investigate the effects of postoperative ACT in patients with stage IA MPNP-LUAD. Methods A total of 149 patients with pathological stage IA MPNP-LUAD who underwent surgery at our center were retrospectively analyzed. Propensity score matching (PSM) analysis was conducted to reduce potential selection bias. Kaplan–Meier analyses were used to assess the impact of ACT on recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS). Subgroup analyses were performed for the survival outcomes based on the percentage of micropapillary components. Cox proportional hazards regression analyses were applied to identify risk factors associated with survival. Results The receipt or non-receipt of postoperative ACT had no significant effect on RFS, OS, and DSS among all enrolled patients with stage IA MPNP-LUAD (P > 0.05). For patients with a micropapillary component > 5%, the 5-year rates of RFS, OS, and DSS were significantly higher in the ACT group compared to the observation group, both before and after PSM (P < 0.05). However, the differences between the two groups were not significant for patients with a micropapillary component ≤ 5% (P > 0.05). The resection range (HR = 0.071; 95% CI: 0.020–0.251; P < 0.001), tumor size (HR = 2.929; 95% CI: 1.171–7.330; P = 0.022), and ACT (HR = 0.122; 95% CI: 0.037–0.403; P = 0.001) were identified as independent prognostic factors for RFS through Cox regression analysis. Conclusion Patients with stage IA MPNP-LUAD who have a micropapillary component greater than 5% might benefit from postoperative ACT, while those with a micropapillary component ≤ 5% did not appear to derive the same benefit from postoperative ACT.

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Does the presence of a micropapillary component predict worse prognosis in pathological stage IA lung adenocarcinoma?

Cited by 2 publications

References 33 publications

Analysis of predictive factors of unforeseen nodal metastases in resected clinical stage I NSCLC

Analysis of predictive factors of unforeseen nodal metastases in resected clinical stage I NSCLC

Prognostic significance and survival benefits of postoperative adjuvant chemotherapy in patients with stage IA lung adenocarcinoma with non-predominant micropapillary components

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