Abstract
Purpose
Tumor spread through air space (STAS) is a novel pattern of invasion related to poor prognosis in non-small cell cancer (NSCLC). Nevertheless, little is known about the role of STAS in small cell lung cancer (SCLC). We sought to determine whether STAS has a significant effect on recurrence among SCLC patients.
Methods
We collected clinical and follow-up information from 181 resected stage I–III SCLC patients and compared overall survival (OS) and disease-free survival (DFS) between the patients with or without STAS using the Kaplan‒Meier method. To explore the effect of STAS on recurrence, a competing-risk analysis was conducted.
Results
Among 181 SCLC patients, STAS was observed in 56 (30.94%) patients, and 125 (69.06%) patients did not have STAS. Furthermore, 33 (18.23%) patients had recurrence, including 12 patients with brain metastases. Patients with STAS had worse DFS. The cumulative incidence of any recurrence was higher in patients with STAS than in those without STAS. Univariate and multivariate competing-risk regression analyses revealed that sublobar resection and STAS were independent risk factors for SCLC recurrence (p = 0.009 and p = 0.029 for multivariate analysis, respectively).
Conclusion
SCLC patients with STAS have worse DFS than SCLC patients without STAS. STAS is an independent prognostic factor in SCLC patients.
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Abbreviations
- STAS:
-
Spread through air space
- SCLC:
-
Small cell lung cancer
- NSCLC:
-
Non-small cell lung cancer
- OS:
-
Overall survival
- DFS:
-
Disease-free survival
- C-index:
-
Concordance index
- MRI:
-
Magnetic resonance imaging
- CIR:
-
Cumulative incidence of recurrence
- CIF:
-
Cumulative incidence of function
- ROC:
-
Receiver operating characteristic
- WHO:
-
World health organization
- RFS:
-
Recurrence-free survival
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Funding
This work was supported by the National Key R&D Program of China (2019YFC1315803), the Shanghai Science and Technology Committee (Grant No. 201409001000), Programs of Shanghai Pulmonary Hospital (No. fkcx1904), and Funding of Shanghai Pulmonary Hospital (Grant No.Lung Cancer Diagnosis and Treatment Center).
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Prof. Zhu YM, Zhang ZH, Song N and Yu HS have full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Han L, Huang ZD, Zhang J and Chen Y equally contributed to this work.
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Yu HS, Zhang ZH, Song N and Zhu YM contributed equally as co-senior and corresponding authors. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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The Institutional Review Board at Shanghai pulmonary hospital approved our retrospective study (Approval number: RSZYM-1).
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Han, L., Huang, Z., Zhang, J. et al. Significance of spread through air spaces in small cell lung cancer. J Cancer Res Clin Oncol 149, 5301–5308 (2023). https://doi.org/10.1007/s00432-022-04462-8
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DOI: https://doi.org/10.1007/s00432-022-04462-8