Prognostic impact of micropapillary component in patients with node‐negative subcentimeter lung adenocarcinoma: A Chinese cohort study

Yao, Jie; Zhu, Erjia; Li, Ming; Liu, Jinshi; Zhang, Lei; Ke, Honggang; Su, Hang; Xie, Huikang; Xu, Guanxin; Zhu, Ling; Fan, Junqiang; Chen, Chang

doi:10.1111/1759-7714.13702

Cited by 15 publications

(9 citation statements)

References 29 publications

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“…Yao et al. ( 19 ) found that patients with subcentimetre lung adenocarcinoma with micropapillary components had a poor prognosis, and wedge resection was associated with a higher risk of recurrence than anatomic lung resection (segmentectomy and lobectomy), which was similar to our results.…”

Section: Discussionsupporting

confidence: 91%

“…When the micropapillary histological components were more than 5%, the survival rate of lobectomy was higher, while in the patients with micropapillary histological components lower than 5%, there was no significant difference in survival rate after different surgical methods. Yao et al (19) found that patients with subcentimetre lung adenocarcinoma with micropapillary components had a poor prognosis, and wedge resection was associated with a higher risk of recurrence than anatomic lung resection (segmentectomy and lobectomy), which was similar to our results.…”

Section: Figuresupporting

confidence: 91%

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The prognostic influence of histological subtypes of micropapillary tumors on patients with lung adenocarcinoma ≤ 2 cm

Zhou

Wang

et al. 2022

Front. Oncol.

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ObjectiveThis study aimed to explore the value of micropapillary histological subtypes in predicting the specific surgical specificity and lymph node metastasis prognosis of early lung adenocarcinoma.MethodsA total of 390 patients with lung adenocarcinoma were included who underwent surgery in the Department of Thoracic Surgery of the Affiliated Provincial Hospital of Anhui Medical University from January 2016 to December 2017. The data were analysed with SPSS 26.0 statistical software, and the clinicopathological data of the two groups were compared with the chi-square test. The survival rate was calculated by the Kaplan-Meier method, and the difference in survival rate between groups was analysed by the log-rank test. Multivariate survival analysis was performed using the Cox model.ResultsUnivariate analysis of the clinicopathological data of the patients showed that the micropapillary histological subtype was significantly associated with the survival rate of patients (p=0.007). The clinicopathological data of the patients were substituted into the Cox model for multivariate analysis, and the results showed that the micropapillary histological subtype was an independent prognostic factor affecting the survival rate of the patients (p=0.009).The average survival time of Group A (micronipple composition > 5%) was 66.7 months; the 1-year, 3-year, and 5-year survival rates were 98.8%, 93.0%, and 80.9%, respectively.The survival of the lobectomy group was better than that of the sublobectomy group and the survival of patients with systematic dissection was better than that of patients with limited lymph node dissection. The average survival time of Group B (micronipple composition ≤ 5%) was 70.5 months; the 1-year, 3-year, and 5-year survival rates were 99.3%, 95.4%, and 90.6%, respectively. There was no difference in the survival rate between the lobectomy group and sublobectomy group, and there was also no difference in survival between systematic lymph node dissection and limited lymph node dissection, The survival rate of Group B was significantly better than that of Group A.ConclusionThe micropapillary histological component is an independent risk factor after surgery in patients with ≤2 cm lung adenocarcinoma. When the proportion of micropapillary components is different, the prognosis of patients is different when different surgical methods and lymph node dissections are performed. Lobectomy and systematic lymph node dissection are recommended for patients with a micropapillary histological composition >5%; sublobar resection and limited lymph node dissection are recommended for patients with a micropapillary histological composition ≤5%.

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Section: Discussionsupporting

confidence: 91%

Section: Figuresupporting

confidence: 91%

The prognostic influence of histological subtypes of micropapillary tumors on patients with lung adenocarcinoma ≤ 2 cm

Zhou

Wang

et al. 2022

Front. Oncol.

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“…Several previous studies have determined that the presence of at least a 5% MPC is inversely associated with survival ( 21 , 22 ). Patients with sub-centimeter LA, with a ≥ 5% MPC, treated with a wedge resection, had a higher risk of recurrence ( 23 ). However, a MPC < 5% has also been determined to have a significant impact on OS ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Genomic and clinicopathological features of lung adenocarcinomas with micropapillary component

Liu

Wang

et al. 2022

Front. Oncol.

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BackgroundLung adenocarcinoma (LA) with a micropapillary component (LAMPC) is a histological subtype of lung cancer that has received increasing attention due to its correlation with poor prognosis, and its tendency to recur and metastasize. At present, comprehensive genomic profiles and clinicopathological features for LAMPC remain unclear and require further investigation.MethodsFrom September 2009 to October 2020, a total of 465 LAMPC patients were recruited and divided into four groups according to MPC proportions, and the correlations between varying proportions of MPCs and clinicopathological characteristics were analyzed. Twenty-nine (29) LAMPC patients and 89 LA patients without MPC (non-MPC) that had undergone NGS testing were selected for further study The comprehensively analyze genomic variations and the difference between LAMPC and MPC were determined. In addition, Gene alterations of LAMPC between Chinese and Western populations were also compared using cBioPortal data.ResultsA higher proportion of MPCs, associated with higher tumor stage, pleural invasion, and vascular tumor thrombus formation, was determined in LA patients. Compared to non-MPC patients, LAMPC patients were determined to have a lower frequency of single nucleotide variants and a higher frequency of insertion-deletion mutations. Mutations in TP53, CTNNB1, and SMAD4, and ALK rearrangements/fusions were significantly more frequent in LAMPC patients. ERBB2 mutations were only detected in non-MPC patients. Gene mutations in the Wnt pathway were significantly more common in LAMPC patients as compared to non-MPC patients. ALK fusions were more prevalent in younger patients. Patients with KRAS or LBP1B mutations had significantly larger tumor diameters than patients with wild-type KRAS or LBP1B. Patients with KRAS mutations were more likely to develop vascular tumor thrombus. Using the cBioPortal public database, we determined that mutations in EGFR were significantly higher in Chinese patients than in a Memorial Sloan Kettering Cancer Center (MSKCC) Western cohort. ALK fusions were exclusively detected in the Chinese cohort, while mutations in KEAP1 and NOTCH4 were only detected in the MSKCC cohort. Our analysis of signaling pathways revealed that Wnt pathway gene mutations were significantly higher in the Chinese cohort.ConclusionLA patients with higher proportions of MPCs were determined to have a higher tumor stage, pleural invasion, and vascular tumor thrombosis formation. We comprehensively analyzed the genomic mutation characteristics of LAMPC patients and identified multiple, novel MPC-related gene alterations and pathway changes. Our data provide further understanding of the nature of the LAMPC and potential drug-targeted gene alterations, which may lead to new therapeutic strategies.

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“… 28 Chen et al had showed wedge resection was associated with higher risk of recurrence compared with anatomic resection for sub‐centimeter lung adenocarcinoma with a micropapillary component of 5% or greater in a cohort 311 patients. 29 Contrarily, unlike micropapillary and solid predominant subtypes, patients with adenocarcinoma ≤1 cm with micropapillary and/or solid component (not predominant) treated with wedge resection did not show inferior RFS and OS compared with anatomical resection ( p = 0.58) in our study. It is noteworthy that the wedge resections in our cohort had a resection margin more than 1 cm, which might suggest the local infiltration for invasive adenocarcinoma ≤1 cm with micropapillary and solid component (not predominant) is less than 1 cm.…”

Section: Discussionmentioning

confidence: 40%

“…Lee et al had reported that even a small component of micropapillary pattern will have a significant prognostic impact on OS 28 . Chen et al had showed wedge resection was associated with higher risk of recurrence compared with anatomic resection for sub‐centimeter lung adenocarcinoma with a micropapillary component of 5% or greater in a cohort 311 patients 29 . Contrarily, unlike micropapillary and solid predominant subtypes, patients with adenocarcinoma ≤1 cm with micropapillary and/or solid component (not predominant) treated with wedge resection did not show inferior RFS and OS compared with anatomical resection ( p = 0.58) in our study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes following lobectomy, segmentectomy, and wedge resection based on pathological subtyping in patients with pN0 invasive lung adenocarcinoma ≤1 cm

et al. 2022

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Purpose We sought to analyze the prognostic significance of lung adenocarcinoma classification for patients with pathological N0 (pN0) lung invasive adenocarcinomas ≤1 cm who underwent surgical resection and investigate the optimal surgical procedure according to lung adenocarcinoma classification. Methods A total of 1409 consecutive patients with resected pN0 invasive lung adenocarcinoma ≤1 cm were retrospectively reviewed. Comprehensive histologic subtyping was determined according to IASLC/ATS/ERS lung adenocarcinoma classification. Recurrence‐free survival (RFS) and overall survival (OS) were compared between patients receiving lobectomy, segmentectomy, and wedge resection. Results RFS and OS favored lobectomy and segmentectomy compared with wedge resection in the entire cohort. Five‐year RFS rates were 100%, 98.2%, 97.3%, 77.8%, and 82.8% (p < 0.001) for lepidic, acinar, papillary, micropapillary, and solid predominant subtypes, while 5‐year OS rates were 100%, 98.4%, 98.1%, 88.9%, and 96.5% (p < 0.001), respectively. Multivariate analysis showed that adenocarcinoma predominant pathological subtype and CT appearance were independent prognostic factors for RFS, and surgical procedure was independent factor for both RFS and OS. Specifically, wedge resection showed worse survival compared with anatomical resection in patients with papillary, micropapillary, or solid predominant subtypes, whereas in patients with lepidic predominant and acinar predominant subtypes, wedge resection showed comparable RFS with anatomical resection. Conclusions Anatomical resection showed better survival for patients with pN0 invasive lung adenocarcinoma ≤1 cm. For patients with invasive adenocarcinoma ≤1 cm in whom anatomical resection is not feasible, wedge resection could provide similar oncological effect when tumor is lepidic predominant or acinar predominant.

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Prognostic impact of micropapillary component in patients with node‐negative subcentimeter lung adenocarcinoma: A Chinese cohort study

Cited by 15 publications

References 29 publications

The prognostic influence of histological subtypes of micropapillary tumors on patients with lung adenocarcinoma ≤ 2 cm

The prognostic influence of histological subtypes of micropapillary tumors on patients with lung adenocarcinoma ≤ 2 cm

Genomic and clinicopathological features of lung adenocarcinomas with micropapillary component

Comparison of outcomes following lobectomy, segmentectomy, and wedge resection based on pathological subtyping in patients with pN0 invasive lung adenocarcinoma ≤1 cm

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