Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma
Abstract Background Whether prognosis differs between lung acinar predominant adenocarcinoma (ACN) and papillary predominant adenocarcinoma (PAP) patients remains controversial. Furthermore, the appropriate surgical plan for each subtype is undetermined. Methods Data of stage I ACN or PAP patients f...
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| Format: | Article |
| Language: | English |
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Wiley
2020-05-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.3012 |
| _version_ | 1818300791144841216 |
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| author | Di Lu Jianjun Yang Xiguang Liu Siyang Feng Xiaoying Dong Xiaoshun Shi Jianxue Zhai Shijie Mai Jianjun Jiang Zhizhi Wang Hua Wu Kaican Cai |
| author_facet | Di Lu Jianjun Yang Xiguang Liu Siyang Feng Xiaoying Dong Xiaoshun Shi Jianxue Zhai Shijie Mai Jianjun Jiang Zhizhi Wang Hua Wu Kaican Cai |
| author_sort | Di Lu |
| collection | DOAJ |
| description | Abstract Background Whether prognosis differs between lung acinar predominant adenocarcinoma (ACN) and papillary predominant adenocarcinoma (PAP) patients remains controversial. Furthermore, the appropriate surgical plan for each subtype is undetermined. Methods Data of stage I ACN or PAP patients from 2004 to 2015 were retrospectively reviewed by SEER*Stat 8.3.5. The primary outcome was overall survival (OS) and lung cancer specific survival (LCSS). Results 1531 patients (PAP, 484; ACN, 1047) were included. ACN patients had better OS (P = .001) and LCSS (P = .003) than PAP patients. Among stage I ACN patients, lobectomy with mediastinal lymph node dissection (Lob) (P = .001) or segmentectomy (Seg) (P = .003) provided a better OS than wedge resection (Wed). And ACN patients who received Lob had a equivalent LCSS, compared to those who received Seg (P = .895). For patients with PAP in stage I, those who received Lob tended to have a better prognosis than that received Seg (HR of OS, 0.605, 95% CI: 0.263‐1.393; HR of LCSS, 0.541, 95% CI: 0.194‐1.504) or Wed (HR of OS, 0.735, 95% CI: 0.481‐1.123; HR of LCSS, 0.688, 95% CI: 0.402‐1.180). Conclusions Among patients with lung adenocarcinoma in stage I, those with ACN have a better OS and LCSS than that with PAP. For patients with stage I ACN, Seg and Lob, rather than Wed, seem to be an equivalent treatment choice; however, Seg is the prior option because it could preserve more lung function than Lob. For patients with PAP, Lob tends to be a better choice than Wed and Seg, although the prognostic difference between them is nonsignificant. |
| first_indexed | 2024-12-13T05:12:43Z |
| format | Article |
| id | doaj.art-29dc7a9b9849415ba08210536040dd25 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-13T05:12:43Z |
| publishDate | 2020-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-29dc7a9b9849415ba08210536040dd252022-12-21T23:58:29ZengWileyCancer Medicine2045-76342020-05-019103455346210.1002/cam4.3012Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinomaDi Lu0Jianjun Yang1Xiguang Liu2Siyang Feng3Xiaoying Dong4Xiaoshun Shi5Jianxue Zhai6Shijie Mai7Jianjun Jiang8Zhizhi Wang9Hua Wu10Kaican Cai11Department of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaDepartment of Thoracic Surgery Nanfang Hospital Southern Medical University Guangzhou ChinaAbstract Background Whether prognosis differs between lung acinar predominant adenocarcinoma (ACN) and papillary predominant adenocarcinoma (PAP) patients remains controversial. Furthermore, the appropriate surgical plan for each subtype is undetermined. Methods Data of stage I ACN or PAP patients from 2004 to 2015 were retrospectively reviewed by SEER*Stat 8.3.5. The primary outcome was overall survival (OS) and lung cancer specific survival (LCSS). Results 1531 patients (PAP, 484; ACN, 1047) were included. ACN patients had better OS (P = .001) and LCSS (P = .003) than PAP patients. Among stage I ACN patients, lobectomy with mediastinal lymph node dissection (Lob) (P = .001) or segmentectomy (Seg) (P = .003) provided a better OS than wedge resection (Wed). And ACN patients who received Lob had a equivalent LCSS, compared to those who received Seg (P = .895). For patients with PAP in stage I, those who received Lob tended to have a better prognosis than that received Seg (HR of OS, 0.605, 95% CI: 0.263‐1.393; HR of LCSS, 0.541, 95% CI: 0.194‐1.504) or Wed (HR of OS, 0.735, 95% CI: 0.481‐1.123; HR of LCSS, 0.688, 95% CI: 0.402‐1.180). Conclusions Among patients with lung adenocarcinoma in stage I, those with ACN have a better OS and LCSS than that with PAP. For patients with stage I ACN, Seg and Lob, rather than Wed, seem to be an equivalent treatment choice; however, Seg is the prior option because it could preserve more lung function than Lob. For patients with PAP, Lob tends to be a better choice than Wed and Seg, although the prognostic difference between them is nonsignificant.https://doi.org/10.1002/cam4.3012acinarlung adenocarcinomapapillarysurgical proceduressurvival |
| spellingShingle | Di Lu Jianjun Yang Xiguang Liu Siyang Feng Xiaoying Dong Xiaoshun Shi Jianxue Zhai Shijie Mai Jianjun Jiang Zhizhi Wang Hua Wu Kaican Cai Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma Cancer Medicine acinar lung adenocarcinoma papillary surgical procedures survival |
| title | Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma |
| title_full | Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma |
| title_fullStr | Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma |
| title_full_unstemmed | Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma |
| title_short | Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma |
| title_sort | clinicopathological features survival outcomes and appropriate surgical approaches for stage i acinar and papillary predominant lung adenocarcinoma |
| topic | acinar lung adenocarcinoma papillary surgical procedures survival |
| url | https://doi.org/10.1002/cam4.3012 |
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