The prognostic role of pathologic invasive component size, excluding lepidic growth, in stage I lung adenocarcinoma
The prognostic role of pathologic invasive component size, excluding lepidic growth, in stage I lung adenocarcinoma
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DOI：
10.1016/j.jtcvs.2013.04.032
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发表时间：
2013-09-01
影响因子：
6
通讯作者：
Okada, Morihito
中科院分区：
文献类型：
--
作者：
Tsutani, Yasuhiro;Miyata, Yoshihiro;Okada, Morihito
目的：我们对肺腺癌患者侵袭性成分大小的预后意义进行了调查，不包括鳞状生长。方法：回顾性分析603例病理完全切除的I期肺腺癌患者的资料，探讨病理肿瘤大小与手术结果的关系。结果：肿瘤总生长部分中位大小为2.2 cm，浸润部分中位大小为1.3 cm。根据侵入性假体大小进行分类的患者无复发生存率差异有统计学意义（2.0 cm; P = 0.026）。多因素Cox回归分析显示，侵袭性成分大小（P = 0.002）、年龄、性别和淋巴浸润是无复发生存的独立预后因素，而肿瘤总大小不是（P = 0.068）。在浸润组件尺寸为0.5 cm及以下组（P = 0.29）和浸润组件尺寸为0.5 ~ 2.0 cm组（P = 0.50）中，接受辅助化疗的患者与未接受辅助化疗的患者的无复发生存率无显著差异。然而，在侵入性组件尺寸大于2.0 cm的组中，接受辅助化疗的患者的无复发生存率明显优于未接受辅助化疗的患者（P = 0.009）。结论：与肿瘤总大小相比，病理浸润成分大小与恶性行为和预后的关系更为显著，在选择病理I期肺腺癌的辅助化疗方案时应特别考虑浸润成分大小。
Objectives: We performed an investigation of the prognostic significance of the invasive component size, excluding lepidic growth, in lung adenocarcinoma patients.Methods: The data from 603 patients with completely resected pathologic stage I lung adenocarcinomas were analyzed retrospectively to determine the relationship between pathologic tumor size and surgicalresults. Results: The median tumor size of the total growth and the invasive component were 2.2 cm and 1.3 cm, respectively. There were significant differences in recurrence-free survival between patients classified on the basis of invasive component sizes ( 2.0 cm; P = .026). A multivariate Cox regression analysis showed that invasive component size (P = .002), age, sex, and lymphatic invasion were independent prognostic factors for recurrence-free survival, whereas total tumor size was not (P = .068). There were no significant differences in recurrence-free survival between patients who received adjuvant chemotherapy and those who did not in the group with invasive component size of 0.5 cm or less (P = .29) and in the group with invasive component size of 0.5 to 2.0 cm (P = .50). However, the recurrence-free survival of patients who received adjuvant chemotherapy was significantly better than that of those who did not in the group with invasive component size greater than 2.0 cm (P = .009).Conclusions: Pathologic invasive component size, as opposed to total tumor size, is associated more significantly with malignant behavior and prognosis and specifically should be considered before choosing candidates for adjuvant chemotherapy in pathologic stage I lung adenocarcinoma.