Kosin Med J.  2023 Jun;38(2):117-125. 10.7180/kmj.23.103.

The solid predominant subtype as an independent risk factor for recurrence in patients with pathologic stage I lung adenocarcinoma

• Lee CH
• Jeon YH

• KMID: 2543331
• DOI: http://doi.org/10.7180/kmj.23.103

Abstract

Background
Increasingly many patients have been diagnosed with stage I adenocarcinoma due to the use of low-dose chest computed tomography for lung cancer screening. Therefore, this study aimed to analyze tumor recurrence based on the predominant subtype in patients with stage I lung adenocarcinoma who underwent lobectomy.
Methods
We retrospectively analyzed 114 patients who underwent lobectomy for pathologic stage I lung adenocarcinoma from June 2001 to July 2019.
Results
In univariate analyses, significant factors were current smoking at the time of surgery (p=0.029), pathologic tumor size (p=0.006), central tumor location (p=0.003), maximum standardized uptake value on positron emission tomography-computed tomography (p=0.001), and the solid predominant subtype (p=0.012). In the multivariate analysis, only the solid predominant subtype (hazard ratio, 9.702; 95% confidence interval, 1.179–79.874; p=0.035) was an independent risk factor.
Conclusions
If the solid subtype is predominant in pathologic findings, adjuvant chemotherapy after standard surgical resection may be considered to help reduce the risk of tumor recurrence and increase survival.

Keyword

Adenocarcinoma; Solid predominant subtype; Recurrence; Recurrence risk factor

Figure

• 

  Fig. 1. Kaplan-Meier analysis for overall survival (5-year overall survival rate; 76.0%) (A), disease-specific survival (5-year disease-specific survival rate; 81.3%) (B), and freedom from recurrence (5-year freedom from recurrence rate; 73.8%) (C) in 114 patients with pathologic stage I adenocarcinoma.

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  Fig. 2. Kaplan-Meier analysis (log-rank test) for the freedom from recurrence rate according to all pathologic predominant subtypes (5-year freedom from recurrence rate; lepidic 100%, acinar 77.2%, papillary 64.2%, and solid 47.1%) (A) and freedom from recurrence rate for non-solid and solid tumors (5-year freedom from recurrence rate; non-solid 78.1% and solid 47.1%) (B).

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  Fig. 3. Kaplan-Meier analysis (log-rank test) for disease-specific survival according to all pathologic predominant subtypes (5-year disease-specific survival rate; lepidic 100%, acinar 82.9%, papillary 81.6%, and solid 53.8%) (A) and disease-specific survival for non-solid and solid tumors (5-year disease-specific survival rate; non-solid 85.3% and solid 53.8%) (B).

• 

  Fig. 4. Kaplan-Meier analysis (log-rank test) for overall survival according to all pathologic predominant subtypes (5-year overall survival rate; lepidic 100%, acinar 73.3%, papillary 78.1%, and solid 57.8%) (A) and overall survival based for non-solid and solid tumors (5-year overall survival rate; non-solid 79.0% and solid 57.8%) (B).

Reference

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