Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine Tumors
Background: Spread through air spaces (STAS) has recently emerged as a prognostic factor in lung adenocarcinoma, but little is known about the association of STAS and its grade with recurrence in neuroendocrine tumors (NETs). This study investigated the prognostic effect of STAS grade in NETs aft...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2022-04-01
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| Series: | Journal of Chest Surgery |
| Subjects: |
| _version_ | 1819025708600524800 |
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| author | Mincheol Chae Sukki Cho Jin-Haeng Chung Sungwon Yum Kwhanmien Kim Sanghoon Jheon |
| author_facet | Mincheol Chae Sukki Cho Jin-Haeng Chung Sungwon Yum Kwhanmien Kim Sanghoon Jheon |
| author_sort | Mincheol Chae |
| collection | DOAJ |
| description | Background: Spread through air spaces (STAS) has recently emerged as a prognostic factor
in lung adenocarcinoma, but little is known about the association of STAS and its grade
with recurrence in neuroendocrine tumors (NETs). This study investigated the prognostic
effect of STAS grade in NETs after curative resection.
Methods: Seventy-seven patients were retrospectively reviewed, including 9 with typical
carcinoid (TC), 6 with atypical carcinoid (AC), 26 with large cell neuroendocrine carcinoma
(LCNEC), and 36 with small cell carcinoma (SCC). STAS was defined as the presence of
floating tumor cells within air spaces in the lung parenchyma beyond the edge of the
main tumor. STAS was classified as grade 1 or 2 depending on whether it was found within
or beyond one ×10 objective lens field away from the main tumor margin, respectively.
Results: Fifty-four patients (70%) had STAS, including 22% with TC, 50% with AC, 69%
with LCNEC, and 86% with SCC. Patients with STAS had more nodal metastasis, lymphatic
and vascular invasion, tumor necrosis, and tumor subtypes other than TC. Among STAS
cases, grade 2 STAS was present in 33% of AC, 78% of LCNEC, and 87% of SCC. The 5-year
recurrence-free survival (RFS) rate was 81%, 63%, and 35% in patients with no STAS, grade
1, and grade 2 STAS, respectively. Multivariate analysis found that grade 2 STAS was an
independent negative prognostic factor for RFS.
Conclusion: Although STAS itself was not associated with a poor prognosis, grade 2 STAS
was an independent negative prognostic factor for RFS. |
| first_indexed | 2024-12-21T05:14:59Z |
| format | Article |
| id | doaj.art-c85cb77cb38f4c6da4afcb2cc2ddaf40 |
| institution | Directory Open Access Journal |
| issn | 2765-1606 2765-1614 |
| language | English |
| last_indexed | 2024-12-21T05:14:59Z |
| publishDate | 2022-04-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj.art-c85cb77cb38f4c6da4afcb2cc2ddaf402022-12-21T19:14:56ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142022-04-01552101107doi.org/10.5090/jcs.21.097Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine TumorsMincheol Chae0https://orcid.org/0000-0001-9280-8514Sukki Cho1https://orcid.org/0000-0002-9309-8865Jin-Haeng Chung2https://orcid.org/0000-0002-6527-3814Sungwon Yum3https://orcid.org/0000-0002-9198-1021Kwhanmien Kim4https://orcid.org/0000-0002-6581-2750Sanghoon Jheon5https://orcid.org/0000-0001-9366-5981Seoul National University Bundang HospitalSeoul National University Bundang HospitalSeoul National University Bundang HospitalSeoul National University Bundang HospitalSeoul National University Bundang HospitalSeoul National University Bundang HospitalBackground: Spread through air spaces (STAS) has recently emerged as a prognostic factor in lung adenocarcinoma, but little is known about the association of STAS and its grade with recurrence in neuroendocrine tumors (NETs). This study investigated the prognostic effect of STAS grade in NETs after curative resection. Methods: Seventy-seven patients were retrospectively reviewed, including 9 with typical carcinoid (TC), 6 with atypical carcinoid (AC), 26 with large cell neuroendocrine carcinoma (LCNEC), and 36 with small cell carcinoma (SCC). STAS was defined as the presence of floating tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. STAS was classified as grade 1 or 2 depending on whether it was found within or beyond one ×10 objective lens field away from the main tumor margin, respectively. Results: Fifty-four patients (70%) had STAS, including 22% with TC, 50% with AC, 69% with LCNEC, and 86% with SCC. Patients with STAS had more nodal metastasis, lymphatic and vascular invasion, tumor necrosis, and tumor subtypes other than TC. Among STAS cases, grade 2 STAS was present in 33% of AC, 78% of LCNEC, and 87% of SCC. The 5-year recurrence-free survival (RFS) rate was 81%, 63%, and 35% in patients with no STAS, grade 1, and grade 2 STAS, respectively. Multivariate analysis found that grade 2 STAS was an independent negative prognostic factor for RFS. Conclusion: Although STAS itself was not associated with a poor prognosis, grade 2 STAS was an independent negative prognostic factor for RFS.spread through air spacesneuroendocrine tumorsprognosisgrade |
| spellingShingle | Mincheol Chae Sukki Cho Jin-Haeng Chung Sungwon Yum Kwhanmien Kim Sanghoon Jheon Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine Tumors Journal of Chest Surgery spread through air spaces neuroendocrine tumors prognosis grade |
| title | Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine Tumors |
| title_full | Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine Tumors |
| title_fullStr | Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine Tumors |
| title_full_unstemmed | Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine Tumors |
| title_short | Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine Tumors |
| title_sort | poor prognosis of grade 2 spread through air spaces in neuroendocrine tumors |
| topic | spread through air spaces neuroendocrine tumors prognosis grade |
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