Jizhuang Luo1, Qingyuan Huang1, Rui Wang1, Baohui Han2, Jie Zhang3, Heng Zhao1, Wentao Fang1, Qingquan Luo4, Jun Yang1, Yunhai Yang1, Lei Zhu3, Tianxiang Chen1, Xinghua Cheng5, Yiyang Wang1, Jiajie Zheng1, Han Wu6, Weicong Xia6, Haiquan Chen7,8,9,10. 1. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 2. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 3. Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 4. Department of Shanghai Lung Tumor Clinic Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. 5. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270, Dong-An Road, Shanghai, 200032, China. 6. Department of Thoracic Surgery, Shanghai Ruijin Hosptial, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 7. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. hqchen1@yahoo.com. 8. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270, Dong-An Road, Shanghai, 200032, China. hqchen1@yahoo.com. 9. Institutes of Biomedical Sciences, Fudan University, Shanghai, China. hqchen1@yahoo.com. 10. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. hqchen1@yahoo.com.
Abstract
PURPOSE: Controversy remains exist for the effect of adjuvant chemotherapy (ACT) among stage IB lung adenocarcinoma patients. This study aimed to investigate the predictive value of the current lung adenocarcinoma classification system on benefit of ACT among patients with stage IB lung adenocarcinoma. METHODS: A total of 928 pathological stage IB invasive adenocarcinoma patients with R0 resection were included in this study. Based on the predominant growth pattern present in the tumor, invasive adenocarcinomas with mixed histologic components were classified into five subtypes: lepidic (LEP), acinar (ACN), papillary (PAP), micropapillary (MIP) and solid (SOL). These five histologic subtypes were collapsed into three groups (LEP, ACN/PAP and SOL/MIP). Disease-free survival (DFS) and overall survival (OS) were analyzed to evaluate benefit from ACT in patients with different histologic patterns using the Kaplan-Meier approach and multivariable Cox models. RESULTS: For all stage IB invasive adenocarcinoma patients, SOL/MIP subgroup presented the worst prognosis, and LEP subgroup showed approximately 100 % 5-year survival. ACT was associated with a better DFS (HR, 0.70; 95 % CI 0.51-0.96, p = .026) for all stage IB patients. In SOL/MIP subgroup, patients could benefit from ACT for a significant improved DFS (HR, 0.81; 95 % CI 0.49-1.35; p = .030), but not for OS (HR, 0.39; 95 % CI 0.12-1.30, p = .111). In ACN/PAP subgroup, there was no significant benefit from ACT for both DFS (HR, 0.76; 95 % CI 0.54-1.08, p = .125) and OS (HR, 0.81; 95 % CI 0.49-1.35, p = .421). CONCLUSIONS: SOL/MIP predominant pattern was predictive for ACT benefit for DFS among invasive lung adenocarcinoma patients in stage IB.
PURPOSE: Controversy remains exist for the effect of adjuvant chemotherapy (ACT) among stage IB lung adenocarcinomapatients. This study aimed to investigate the predictive value of the current lung adenocarcinoma classification system on benefit of ACT among patients with stage IB lung adenocarcinoma. METHODS: A total of 928 pathological stage IB invasive adenocarcinomapatients with R0 resection were included in this study. Based on the predominant growth pattern present in the tumor, invasive adenocarcinomas with mixed histologic components were classified into five subtypes: lepidic (LEP), acinar (ACN), papillary (PAP), micropapillary (MIP) and solid (SOL). These five histologic subtypes were collapsed into three groups (LEP, ACN/PAP and SOL/MIP). Disease-free survival (DFS) and overall survival (OS) were analyzed to evaluate benefit from ACT in patients with different histologic patterns using the Kaplan-Meier approach and multivariable Cox models. RESULTS: For all stage IB invasive adenocarcinomapatients, SOL/MIP subgroup presented the worst prognosis, and LEP subgroup showed approximately 100 % 5-year survival. ACT was associated with a better DFS (HR, 0.70; 95 % CI 0.51-0.96, p = .026) for all stage IB patients. In SOL/MIP subgroup, patients could benefit from ACT for a significant improved DFS (HR, 0.81; 95 % CI 0.49-1.35; p = .030), but not for OS (HR, 0.39; 95 % CI 0.12-1.30, p = .111). In ACN/PAP subgroup, there was no significant benefit from ACT for both DFS (HR, 0.76; 95 % CI 0.54-1.08, p = .125) and OS (HR, 0.81; 95 % CI 0.49-1.35, p = .421). CONCLUSIONS: SOL/MIP predominant pattern was predictive for ACT benefit for DFS among invasive lung adenocarcinomapatients in stage IB.
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