High-risk characteristics of pathological stage I lung adenocarcinoma after resection: patients for whom adjuvant chemotherapy should be performed
Lei-Lei Wu,
Wen-Mei Jiang,
Jia-Yi Qian,
Jia-Yuan Tian,
Zhi-Xin Li,
Kun Li,
Guo-Wei Ma,
Dong Xie,
Chang Chen
Affiliations
Lei-Lei Wu
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 200092, PR China
Wen-Mei Jiang
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510000, PR China
Jia-Yi Qian
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 200092, PR China
Jia-Yuan Tian
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510000, PR China
Zhi-Xin Li
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 200092, PR China
Kun Li
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 200092, PR China
Guo-Wei Ma
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510000, PR China
Dong Xie
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 200092, PR China; Corresponding author. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, PR China.
Chang Chen
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 200092, PR China; Corresponding author. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, PR China.
Background: The objective of the present study was to identify patients with pathologic stage I lung adenocarcinoma (LUAD) who are at high risk of recurrence and assess the efficacy of adjuvant chemotherapy (ACT) in these individuals. Methods: A retrospective study was conducted on 1504 patients with pathologic stage I LUAD who underwent surgical resection at Shanghai Pulmonary Hospital and Sun Yat-sen University Cancer Center. Cox proportional hazard regression analyses were performed to identify indicators associated with a high risk of recurrence, while the Kaplan-Meier method and Log-rank test were employed to compare recurrence-free survival (RFS) and overall survival (OS) between patients with ACT and those without it. Results: Four independent indicators, including age (≥62 years), visceral pleural invasion (VPI), predominant pattern (micropapillary/solid), and lymphovascular invasion (LVI), were identified to be significantly related with RFS. Subsequently, patients were classified into high-risk and low-risk groups by LVI, VPI, and predominant pattern. The administration of ACT significantly increased both RFS (P < 0.001) and OS (P = 0.03) in the high-risk group (n = 250). Conversely, no significant difference was observed in either RFS (P = 0.45) or OS (P = 0.063) between ACT and non-ACT patients in the low-risk group (n = 1254). Conclusions: Postoperative patients with stage I LUAD with factors such as LVI, VPI, and micropapillary/solid predominant pattern may benefit from ACT.
