Recurrence Pattern of Pathologic Stage I Lung Adenocarcinoma With Visceral Pleural Invasion
Recurrence Pattern of Pathologic Stage I Lung Adenocarcinoma With Visceral Pleural Invasion
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DOI：
10.1016/j.athoracsur.2016.09.052
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发表时间：
2017-04-01
影响因子：
4.6
通讯作者：
Jheon, Sanghoon
中科院分区：
文献类型：
--
作者：
Jiwangga, Dhihintia;Cho, Sukki;Jheon, Sanghoon
背景内脏胸膜侵犯（VPI）是众所周知的肺腺癌预后不良的因素。很少有研究报告肺腺癌VPI术后复发模式。本研究旨在评价VPI对I期肺腺癌根治性切除术后复发模式的临床疗效。回顾性分析了2003年至2012年间574例完全切除后病理I期肺腺癌患者中89例（16%）复发患者的临床病理特征。比较VPI组和非VPI组的病理结果、复发后生存率和复发模式。中位随访时间为53.6个月。43例患者（I组）发现VPI，46例患者（II组）未发现VPI。组I中的总肿瘤大小和浸润性大小均较大（3.2对2.7 cm和2.5对2.1 cm; p < 0.05）。组I和组II的中位总生存期分别为58个月和76个月。作为复发模式，在25例患者中发现胸膜种植，I组的胸膜种植百分比显著高于II组（44.2% vs 13.0%; p = 0.001）。在I组中，双侧肺转移明显常见（39.5%对13.0%; p = 0.004），并且随着侵袭性肿瘤大小的增加，观察到胸膜种植百分比增加。VPI的存在是一个重要的预测因素胸膜种植和双侧肺转移的模式后，完全切除病理I期肺腺癌的复发。(C)2017胸外科医师协会
Background. Visceral pleural invasion (VPI) is well known to be a poor prognostic factor in lung adenocarcinoma. There were few studies reporting postoperative recurrence pattern in lung adenocarcinoma with VPI. This study was to evaluate the clinical effect of VPI on recurrence pattern in pathologic stage I lung adenocarcinoma after curative resection.Methods. Among 574 patients with pathologic stage I lung adenocarcinoma after complete resection between 2003 and 2012, the clinicopathologic characteristics of 89 patients (16%) who had recurrence were retrospectively reviewed. The pathologic findings, postrecurrence survival, and patterns of recurrence were compared between patients with VPI and without VPI.Results. Median follow-up duration was 53.6 months. The VPI was found in 43 patients (group I) and not found in 46 patients (group II). Both total tumor size and invasive size were larger in group I (3.2 versus 2.7 cm and 2.5 versus 2.1 cm; p < 0.05). The median duration of overall survival was 58 months in group I and 76 months in group II. As patterns of recurrence, pleural seeding was found in 25 patients, and the percentage of pleural seeding was significantly higher in group I than group II (44.2% versus 13.0%; p = 0.001). In group I, bilateral lung metastasis was significantly common (39.5% versus 13.0%; p = 0.004), and increasing percentage of pleural seeding was observed as the invasive tumor size grows.Conclusions. The presence of VPI was a significant predictable factor for pleural seeding and bilateral lung metastasis as patterns of recurrence after complete resection in pathologic stage I lung adenocarcinoma. (C) 2017 by The Society of Thoracic Surgeons