High-Risk Factors for Recurrence of Stage I Lung Adenocarcinoma: Follow-up Data From JCOG0201

Tsutani, Yasuhiro; Suzuki, Kenji; Koike, Teruaki; Wakabayashi, Masashi; Mizutani, Tomonori; Aokage, Keiju; Saji, Hisashi; Nakagawa, Kazuo; Zenke, Yoshitaka; Takamochi, Kazuya; Ito, Hiroyuki; Aoki, Tadashi; Okami, Jiro; Yoshioka, Hiroshige; Okada, Morihito; Watanabe, Shun‐ichi

doi:10.1016/j.athoracsur.2019.05.080

Cited by 25 publications

(17 citation statements)

References 31 publications

(34 reference statements)

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“…Among metastatic cases of NSCLC, vascular invasion, large invasive size, and advanced stage were independent risk factors of early recurrence. Although these factors and others-such as lymphatic permeation and pleural invasion-are known prognostic factors for recurrence-free survival, the risk factors for early recurrence have not been evaluated previously [5][6][7][8][9]. Cases of NSCLC with vascular invasion would require frequent examination including systemic radiological evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, NSCLC recurrence, even after complete resection, is still frequently observed in clinical settings [3,4]. Many studies have identified some clinicopathological factors that could predict the postoperative prognosis of patients with NSCLC [5][6][7][8][9]. Thus, identifying predictors of recurrence in patients with completely resected NSCLC would be very helpful in determining whether a shorter period systemic evaluation should be performed during follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathological Factors Related to Recurrence Patterns of Resected Non-Small Cell Lung Cancer

Shimizu

Kinoshita

Sasaki

et al. 2020

JCM

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Even after complete resection, non-small cell lung cancer (NSCLC) shows preferential recurrence in the mediastinal lymph nodes, lungs, brain, bone, liver, and adrenal gland. However, the relationship between clinicopathological factors and recurrence patterns after resection has not been well-evaluated. Among 688 NSCLC cases with complete resection between 2004 and 2016, 233 cases recurred at our institute. On multivariate analyses, NSCLCs with lymph node metastasis and pulmonary metastasis at surgery commonly recurred in the mediastinal lymph nodes and lungs, respectively. Young age, adenocarcinoma, and vascular invasion were correlated with brain metastasis. Although no variable was associated with bone metastasis, vascular invasion was correlated with postoperative liver and adrenal gland metastasis. Pathologically proven stage II or III NSCLC, adenocarcinoma, and the presence of lymphatic permeation would result in multiple metastases. Vascular invasion, larger invasive size, and advanced stage were independent risk factors of early recurrence. Considering survival, vascular invasion, elderly age, and non-adenocarcinoma were unfavorable prognostic factors after recurrence. Some clinicopathological variables were correlated with organ-specific metastasis and post-recurrence survival. Particularly, vascular invasion was a biomarker of brain, liver, and adrenal gland metastases and a prognostic marker after recurrence among completely resected NSCLC. This information is useful for more frequent patient follow-up and identifying organ-specific distant metastasis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinicopathological Factors Related to Recurrence Patterns of Resected Non-Small Cell Lung Cancer

Shimizu

Kinoshita

Sasaki

et al. 2020

JCM

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“…The invasive components in MPNs, including minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC), are demonstrated to be an important precise prognostic discriminator and better than the T descriptor of the TNM staging system 6,7 . However, there is still little understanding of the initiation, early progression, and evolutionary patterns of invasive components in MPNs 8,9 .…”

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confidence: 99%

Tumor evolutionary trajectories during the acquisition of invasiveness in early stage lung adenocarcinoma

Wang

Zhang

et al. 2020

Nat Commun

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The evolutionary trajectories of early lung adenocarcinoma (LUAD) have not been fully elucidated. We hypothesize that genomic analysis between pre-invasive and invasive components will facilitate the description of LUAD evolutionary patterns. We micro-dissect malignant pulmonary nodules (MPNs) into paired pre-invasive and invasive components for panel-genomic sequencing and recognize three evolutionary trajectories. Evolutionary mode 1 (EM1) demonstrates none of the common driver events between paired components, but another two modes, EM2A and EM2B, exhibit critical private alterations restricted to pre-invasive and invasive components, respectively. When ancestral clones harbor EGFR mutations, truncal mutation abundance significantly decrease after the acquisition of invasiveness, which may be associated with the intratumoral accumulation of infiltrated B cells. Harboring EGFR mutations is critical to the selective pressure and further impacts the prognosis. Our findings extend the understanding of evolutionary trajectories during invasiveness acquisition in early LUAD.

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“…(2) preoperative serum test records available, including SCC, NSE, CEA, and CYFRA21-1; (3) preoperative diagnostic CT records showing the size and location of the lesion, with nondetectable or small volume of pleural fluids (<100 ml by CT measurement) [11,12]; (4) no distant metastases (pleural invasion was not necessarily considered to be proximal metastasis since the location is next to the lung [13,14]) confirmed by bronchoscopy, contrast-enhanced CT scan of the chest and brain, bone ECT, color Doppler ultrasonography of the superficial lymph nodes, liver, and adrenal, and PET [15]; and (5) postoperative pathology findings available. The pleural-invaded group included patients with pleural invasion lesions found during surgery and confirmed by pathology, whereas those in the control group were without pleural invasion lesions confirmed during surgery or suspected lesions confirmed to be pleural noninvasive lesions by pathology.…”

Section: Methodsmentioning

confidence: 99%

Prediction of Pleural Invasion in Challenging Non-Small-Cell Lung Cancer Patients Using Serum and Imaging Markers

Zhu

Chen

et al. 2020

Disease Markers

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Introduction. Preoperative detection of pleural invasion in lung cancer patients is key to curative surgical treatment. We tried to predict pleural invasion in non-small-cell lung cancer patients with <100 ml pleural fluid. Methods. Patients admitted from August 1, 2011, to December 31, 2018, were retrospectively retrieved. Records of serum and imaging markers were analyzed. Results. Among 7004 patients who received surgery, 43 cases with <100 ml pleural fluid who had pleural invasion were included, and another 108 cases without pleural invasion were enrolled as controls. There were no differences in squamous cell carcinoma antigen (SCC) or neuron-specific enolase (NSE) values between the pleural invasion and noninvasion groups (p = 0:30 and 0.14, respectively), but there were significant differences in carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA21-1) values (p < 0:01 and 0.01, respectively). There were significant differences in the location of original lung cancer (right mid lobe, p = 0:01), maximum lung lesion diameter (p < 0:01), volume of pleural fluid (nondetectable vs. detectable fluid, p < 0:01), pleural sign (p = 0:03), and positron emission tomography/computed tomography-(PET/CT-) predicted pleural invasion (p = 0:02) between the pleural invasion and noninvasion groups. The maximum Area-Under-the-Curve in the Receiver Operating Characteristic curve analysis was achieved with the combination of CEA, CYFRA21-1, detectable pleural fluid, PET/CT prediction, pleural sign, and location of the lung lesion. Conclusions. Serum CEA and CYFRA21-1, location of original lung cancer (right mid lobe), maximum diameter, CT-detectable pleural fluid, pleural sign by CT, and PET/CT-predicted pleural invasion were good markers for the prediction of pleural invasion in non-small-cell lung cancer patients.

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High-Risk Factors for Recurrence of Stage I Lung Adenocarcinoma: Follow-up Data From JCOG0201

Cited by 25 publications

References 31 publications

Clinicopathological Factors Related to Recurrence Patterns of Resected Non-Small Cell Lung Cancer

Clinicopathological Factors Related to Recurrence Patterns of Resected Non-Small Cell Lung Cancer

Tumor evolutionary trajectories during the acquisition of invasiveness in early stage lung adenocarcinoma

Prediction of Pleural Invasion in Challenging Non-Small-Cell Lung Cancer Patients Using Serum and Imaging Markers

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