Jizhuang Luo1, Rui Wang1, Baohui Han2, Jie Zhang3, Heng Zhao1, Wentao Fang1, Qingquan Luo4, Jun Yang1, Yunhai Yang1, Lei Zhu3, Tianxiang Chen1, Xinghua Cheng5, Qingyuan Huang1, Yiyang Wang1, Jiajie Zheng1, Haiquan Chen6,7,8,9. 1. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China. 2. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China. 3. Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China. 4. Department of Shanghai Lung Tumor Clinic Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China. 5. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270, Dong-An Road, Shanghai, 200032, People's Republic of China. 6. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China. hqchen1@yahoo.com. 7. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270, Dong-An Road, Shanghai, 200032, People's Republic of China. hqchen1@yahoo.com. 8. Institutes of Biomedical Sciences, Fudan University, Shanghai, People's Republic of China. hqchen1@yahoo.com. 9. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. hqchen1@yahoo.com.
Abstract
PURPOSE: The correlations between histological, clinical features and prognosis of stage I invasive mucinous adenocarcinoma (IMA) have not been thoroughly studied for its rare incidence. This study aimed to compare the prognosis among IMA with different percentage of mucinous component and the effect of adjuvant chemotherapy on IMA patients. METHODS: A total of 145 stage I IMA and 3536 invasive nonmucinous adenocarcinoma patients with R0 resection were included. Based on the percentage of mucinous pattern presented in tumor, IMA were classified into two subgroups: pure mucinous (>90 % invasive mucinous pattern) and mixed mucinous/nonmucinous (≥10 % of each histologic component). Invasive nonmucinous adenocarcinomas were classified into three subgroups: lepidic (LEP), acinar/papillary (ACN/PAP) and solid/micropapillary (SOL/MIP). Disease-free survival (DFS) and overall survival (OS) were assessed and compared among IMA and invasive nonmucinous patients. RESULTS: For IMA patients, DFS (p = 0.003) was worse for mixed mucinous/nonmucinous compared with pure mucinous subgroup, OS (p = 0.514) was not prognostically different between two groups. There were no significant difference for DFS (p = 0.428) and OS (p = 0.232) between IMA and invasive nonmucinous adenocarcinoma. However, statistical significance were seen for DFS (p < 0.001) and OS (p < 0.001) between 5 major histological subgroups: LEP and pure IMA showed excellent prognosis, mixed mucinous/nonmucinous IMA and SOL/MIP subtypes presented the worst prognosis. No significant survival benefit from adjuvant chemotherapy for IMA patients. CONCLUSIONS: Mixed mucinous/nonmucinous IMA had a worse DFS compared with pure mucinous. Early stage IMA could not benefit from adjuvant chemotherapy.
PURPOSE: The correlations between histological, clinical features and prognosis of stage I invasive mucinous adenocarcinoma (IMA) have not been thoroughly studied for its rare incidence. This study aimed to compare the prognosis among IMA with different percentage of mucinous component and the effect of adjuvant chemotherapy on IMApatients. METHODS: A total of 145 stage I IMA and 3536 invasive nonmucinous adenocarcinomapatients with R0 resection were included. Based on the percentage of mucinous pattern presented in tumor, IMA were classified into two subgroups: pure mucinous (>90 % invasive mucinous pattern) and mixed mucinous/nonmucinous (≥10 % of each histologic component). Invasive nonmucinous adenocarcinomas were classified into three subgroups: lepidic (LEP), acinar/papillary (ACN/PAP) and solid/micropapillary (SOL/MIP). Disease-free survival (DFS) and overall survival (OS) were assessed and compared among IMA and invasive nonmucinous patients. RESULTS: For IMApatients, DFS (p = 0.003) was worse for mixed mucinous/nonmucinous compared with pure mucinous subgroup, OS (p = 0.514) was not prognostically different between two groups. There were no significant difference for DFS (p = 0.428) and OS (p = 0.232) between IMA and invasive nonmucinous adenocarcinoma. However, statistical significance were seen for DFS (p < 0.001) and OS (p < 0.001) between 5 major histological subgroups: LEP and pure IMA showed excellent prognosis, mixed mucinous/nonmucinous IMA and SOL/MIP subtypes presented the worst prognosis. No significant survival benefit from adjuvant chemotherapy for IMApatients. CONCLUSIONS: Mixed mucinous/nonmucinous IMA had a worse DFS compared with pure mucinous. Early stage IMA could not benefit from adjuvant chemotherapy.
Entities:
Keywords:
Adjuvant chemotherapy; Classification; Invasive mucinous adenocarcinoma; NSCLC; Stage I
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