Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma. (24th March 2020)

• Record Type: Journal Article
• Authors: Lu, Di; Yang, Jianjun; Liu, Xiguang; Feng, Siyang; Dong, Xiaoying; Shi, Xiaoshun; Zhai, Jianxue; Mai, Shijie; Jiang, Jianjun; Wang, Zhizhi; Wu, Hua; Cai, Kaican
• Is Part Of: Cancer medicine. Volume 9:Number 10(2020)
• Page Start: 3455
• Page End: 3462
• Publication Date: 2020-03-24
• Subjects: acinar -- lung adenocarcinoma -- papillary -- surgical procedures -- survival; 616.994005
• DOI: 10.1002/cam4.3012
• Languages: English
• ISSNs: 2045-7634

Abstract

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. Abstract : This SEER based study which we aimed to evaluate the prognosis difference of acinar predominant carcinoma (ACN) and papillary predominant adenocarcinoma (PAP) patients after lobectomy with mediastinal lymph node dissection and explored the best surgical treatment for each type. Our data suggested that 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, and for patients with PAP, Lob tends to be a better choice than Wed and Seg, although the prognostic difference between them is nonsignificant.