Prognostic Factors of Non-Predominant-Lepidic Lung Adenocarcinoma Presenting as Ground Glass Opacity: Results of a Multicenter Study
-
Published:2024-01-30
Issue:2
Volume:14
Page:153
-
ISSN:2075-4426
-
Container-title:Journal of Personalized Medicine
-
language:en
-
Short-container-title:JPM
Author:
Messa Fabiana1ORCID, Siciliani Alessandra1, Piccioni Giorgia1, Leonardi Beatrice2ORCID, Ciccone Anna Maria1, D’Andrilli Antonio1, Andreetti Claudio1, Menna Cecilia1, Vanni Camilla1, Baccarini Alberto Emiliano1, Tiracorrendo Matteo1, Mancini Massimiliano3ORCID, Vecchione Andrea3ORCID, Nocera Adriana4ORCID, Calabrese Giuseppe4, Meacci Elisa4ORCID, Margaritora Stefano4, Natale Giovanni2, Fiorelli Alfonso2ORCID, Venuta Federico5, Rendina Erino Angelo1, Maurizi Giulio1, Ibrahim Mohsen1
Affiliation:
1. Department of Thoracic Surgery, Sant’Andrea Hospital, Sapienza University, Via di Grottarossa 1035, 00189 Rome, Italy 2. Thoracic Surgery Unit, Università degli Studi della Campania “Luigi Vanvitelli”, 80131 Naples, Italy 3. Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, 00189 Rome, Italy 4. Division of Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy 5. Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University, 00161 Rome, Italy
Abstract
This study aims to define the clinicopathological characteristics and prognosis of non-predominant lepidic invasive adenocarcinoma presenting as Ground Glass Opacity (GGO) nodules. The goal is to assess statistical relationships between histology, tumor size, location, and the incidence of relapse and lymph node dissemination. A retrospective multicenter study was conducted, including patients with GGO observed on CT scans between 2003 and 2021. Anamnestic, radiological, and histological data, as well as SUV values, lymphatic and vascular invasion, pathological stage, resection type, and adjuvant treatment, were analyzed. The primary endpoints were to evaluate prognostic factors for death and recurrence using Cox regression analysis. All 388 patients, including 277 with non-predominant lepidic invasive adenocarcinoma and 161 with lepidic adenocarcinoma, underwent curative anatomical resection. Non-predominant lepidic invasive adenocarcinoma demonstrated a worse prognosis than lepidic adenocarcinoma (p = 0.001). Independent prognostic factors for death and recurrence included lymph node involvement (p = 0.002) and vascular and lymphatic invasion (p < 0.001). In conclusion, non-predominant lepidic invasive adenocarcinoma and lymphatic and vascular invasion are prognostic factors for death and recurrence in GGO patients. Results suggest adjuvant treatment in the case of pN1-N2 disease, emphasizing the necessity of lymphadenectomy (sampling or systematic) for accurate staging and subsequent therapeutic procedures.
Subject
Medicine (miscellaneous)
Reference22 articles.
1. Travis, W.D., Brambilla, E., Burke, A.P., Marx, A., and Nicholson, A.G. (2015). WHO Classification of Tumors of Lung Pleura, Thymus and Heart, IARC. 2. Adenocarcinoma classification: Pattern and prognosis;Kuhn;Pathologica,2018 3. Adenocarcinoma in situ, minimally invasive adenocarcinoma, and invasiv pulmonary adenocarcinoma analysis of inerobserver agreement, survival, radiographic characteristics and gross pathology in nodules;Boland;Hum. Pathol.,2016 4. Controversies and chalelenges in the histologic subtyping of lung adenocarcinoma;Butnor;Trans. Lung Cancer Res.,2020 5. Radiologic classification of small adenocarcinoma of the lung: Radiologic-pathologic correlation and its prognostic impact;Suzuki;Ann. Thorac. Surg.,2006
|
|