PMID- 38496684 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240319 IS - 2218-6751 (Print) IS - 2226-4477 (Electronic) IS - 2218-6751 (Linking) VI - 13 IP - 2 DP - 2024 Feb 29 TI - The presence of micropapillary and/or solid subtypes is an independent prognostic factor for patients undergoing curative resection for stage I lung adenocarcinoma with ground-glass opacity. PG - 256-268 LID - 10.21037/tlcr-23-736 [doi] AB - BACKGROUND: Non-predominant or even minimal micropapillary and/or solid (MP/S) subtypes have been reported to exert an unfavorable prognostic influence on surgically resected lung adenocarcinoma (ADC). Currently, there is a lack of evidence to demonstrate that high-grade pathological subtypes, including MP/S components, impact the prognosis of patients with surgically resected lung ADCs with ground-glass opacity (GGO). In this investigation, we explored the prognostic implications of minimal MP/S components in lung ADCs with GGO. METHODS: A retrospective cohort study was conducted on 1,004 consecutive patients undergoing curative resection for pathologic stage (p-stage) I lung ADCs featuring GGO on computed tomography (CT) scans between January 2014 and December 2016. Tumors were categorized into MP/S positive (MP/S(+)) group and MP/S negative (MP/S(-)) group. MP/S(+) tumors were defined when MP/S subtypes constituted >/=1% of the entire tumor. The prognostic impact of MP/S subtypes was evaluated using Kaplan-Meier analysis, Cox proportional hazard model and restricted cubic spine (RCS) model. RESULTS: A total of 86 (8.6%) cases with MP/S(+) tumors and 918 (91.4%) cases with MP/S(-) tumors were identified. The solid component tumor diameter and pathological invasive tumor size of MP/S(+) tumors were both significantly larger than that of MP/S(-) tumors (13.0 vs. 4.0 mm, P<0.001, and 18.0 vs. 10.0 mm, P<0.001, respectively). After a median follow-up of 7.3 years, the presence of MP/S components was significantly associated with decreased RFS (5-year RFS, MP/S(+) 88.3% vs. MP/S(-) 97.4%; P<0.001; HR =1.02). The presence of a histologic lepidic (Lep) component demonstrated a prognostic advantage in both MP/S(-) (5-year RFS, MP/S(-)Lep+ 98.0% vs. MP/S(-)Lep- 95.3%; P=0.01; HR =0.89) and MP/S(+) subgroups (5-year RFS, MP/S(+)Lep+ 93.4% vs. MP/S(+)Lep- 83.2%; P=0.10; HR =0.84). MP/S(+) components >/=5% were the only tumor-related factor that independently affected RFS [hazard ratio (HR) =1.77; 95% confidence interval (CI): 1.07-2.94] according to multivariate analysis. There was a progressively negative impact of the proportion of MP/S subtypes on RFS as illustrated by RCS model. CONCLUSIONS: The presence of MP/S patterns in stage I GGO-featured lung ADCs exhibit significant prognostic value and may have implications for tailored postoperative treatment and surveillance strategies, especially when the proportion exceeds 5% of the entire tumor. CI - 2024 Translational Lung Cancer Research. All rights reserved. FAU - Li, Runze AU - Li R AD - Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Li, Zhifei AU - Li Z AD - Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Yang, Zhenlin AU - Yang Z AD - Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Qiu, Bin AU - Qiu B AD - Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Tan, Fengwei AU - Tan F AD - Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Xue, Qi AU - Xue Q AD - Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Gao, Shugeng AU - Gao S AD - Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - He, Jie AU - He J AD - Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. LA - eng PT - Journal Article DEP - 20240220 PL - China TA - Transl Lung Cancer Res JT - Translational lung cancer research JID - 101646875 PMC - PMC10938098 OTO - NOTNLM OT - Lung cancer OT - adenocarcinoma (ADC) OT - ground-glass opacity (GGO) OT - micropapillary OT - solid COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-23-736/coif). B.Q. serves as an Associate Editor-in-Chief of Translational Lung Cancer Research from September 2023 to August 2024. The other authors have no conflicts of interest to declare. EDAT- 2024/03/18 06:43 MHDA- 2024/03/18 06:44 PMCR- 2024/02/29 CRDT- 2024/03/18 04:41 PHST- 2023/11/17 00:00 [received] PHST- 2024/01/22 00:00 [accepted] PHST- 2024/03/18 06:44 [medline] PHST- 2024/03/18 06:43 [pubmed] PHST- 2024/03/18 04:41 [entrez] PHST- 2024/02/29 00:00 [pmc-release] AID - tlcr-13-02-256 [pii] AID - 10.21037/tlcr-23-736 [doi] PST - ppublish SO - Transl Lung Cancer Res. 2024 Feb 29;13(2):256-268. doi: 10.21037/tlcr-23-736. Epub 2024 Feb 20.