Sarina Bains1, Takashi Eguchi2, Arne Warth3, Yi-Chen Yeh4, Jun-Ichi Nitadori5, Kaitlin M Woo6, Teh-Ying Chou7, Hendrik Dienemann8, Thomas Muley9, Jun Nakajima5, Aya Shinozaki-Ushiku10, Yu-Chung Wu11, Shaohua Lu12, Kyuichi Kadota13, David R Jones1, William D Travis14, Kay See Tan6, Prasad S Adusumilli15. 1. Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. 2. Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Division of Thoracic Surgery, Department of Surgery, Shinshu University, Matsumoto, Japan. 3. Institute of Pathology, Heidelberg University, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany. 4. Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 5. Department of Thoracic Surgery, University of Tokyo, Tokyo, Japan. 6. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York. 7. Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. 8. Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany; Department of Thoracic Surgery, Thoraxklinik at Heidelberg University, Heidelberg, Germany. 9. Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany; Translational Research Unit, Thoraxklinik at Heidelberg University, Heidelberg, Germany. 10. Department of Pathology, University of Tokyo, Tokyo, Japan. 11. Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan. 12. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China. 13. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Diagnostic Pathology, Kagawa University, Kagawa, Japan. 14. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York. 15. Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: adusumip@mskcc.org.
Abstract
INTRODUCTION: This work was performed to develop and validate procedure-specific risk prediction for recurrence following resection for early-stage lung adenocarcinoma (ADC) and investigate risk prediction utility in identifying patients who may benefit from adjuvant chemotherapy (ACT). METHODS: In patients who underwent resection for small (≤2 cm) lung ADC (lobectomy, 557; sublobar resection, 352), an association between clinicopathologic variables and risk of recurrence was assessed by a competing risks approach. Procedure-specific risk prediction was developed based on multivariable regression for recurrence. External validation was conducted using cohorts (N = 708) from Japan, Taiwan, and Germany. The accuracy of risk prediction was measured using a concordance index. We applied the lobectomy risk prediction approach to a propensity score-matched cohort of patients with stage II-III disease (n = 316, after matching) with or without ACT and compared lung cancer-specific survival between groups among low- or high-risk scores. RESULTS: Micropapillary pattern, solid pattern, lymphovascular invasion, and necrosis were involved in the risk prediction following lobectomy, and micropapillary pattern, spread through air spaces, lymphovascular invasion, and necrosis following sublobar resection. Both internal and external validation showed good discrimination (concordance index in lobectomy and sublobar resection: internal, 0.77 and 0.75, respectively; and external, 0.73 and 0.79, respectively). In the stage II-III propensity score-matched cohort, among high-risk patients, ACT significantly reduced the risk of lung cancer-specific death (subhazard ratio 0.43, p = 0.001), but not among low-risk patients. CONCLUSIONS: Procedure-specific risk prediction for patients with resected small lung ADC can be used to better prognosticate and stratify patients for further interventions.
INTRODUCTION: This work was performed to develop and validate procedure-specific risk prediction for recurrence following resection for early-stage lung adenocarcinoma (ADC) and investigate risk prediction utility in identifying patients who may benefit from adjuvant chemotherapy (ACT). METHODS: In patients who underwent resection for small (≤2 cm) lung ADC (lobectomy, 557; sublobar resection, 352), an association between clinicopathologic variables and risk of recurrence was assessed by a competing risks approach. Procedure-specific risk prediction was developed based on multivariable regression for recurrence. External validation was conducted using cohorts (N = 708) from Japan, Taiwan, and Germany. The accuracy of risk prediction was measured using a concordance index. We applied the lobectomy risk prediction approach to a propensity score-matched cohort of patients with stage II-III disease (n = 316, after matching) with or without ACT and compared lung cancer-specific survival between groups among low- or high-risk scores. RESULTS: Micropapillary pattern, solid pattern, lymphovascular invasion, and necrosis were involved in the risk prediction following lobectomy, and micropapillary pattern, spread through air spaces, lymphovascular invasion, and necrosis following sublobar resection. Both internal and external validation showed good discrimination (concordance index in lobectomy and sublobar resection: internal, 0.77 and 0.75, respectively; and external, 0.73 and 0.79, respectively). In the stage II-III propensity score-matched cohort, among high-risk patients, ACT significantly reduced the risk of lung cancer-specific death (subhazard ratio 0.43, p = 0.001), but not among low-risk patients. CONCLUSIONS: Procedure-specific risk prediction for patients with resected small lung ADC can be used to better prognosticate and stratify patients for further interventions.
Authors: Raj G Vaghjiani; Yusuke Takahashi; Takashi Eguchi; Shaohua Lu; Koji Kameda; Zachary Tano; Jordan Dozier; Kay See Tan; David R Jones; William D Travis; Prasad S Adusumilli Journal: J Thorac Oncol Date: 2020-01-30 Impact factor: 15.609
Authors: Rania G Aly; Natasha Rekhtman; Xiaoyu Li; Yusuke Takahashi; Takashi Eguchi; Kay See Tan; Charles M Rudin; Prasad S Adusumilli; William D Travis Journal: J Thorac Oncol Date: 2019-05-20 Impact factor: 15.609
Authors: Andre L Moreira; Paolo S S Ocampo; Yuhe Xia; Hua Zhong; Prudence A Russell; Yuko Minami; Wendy A Cooper; Akihiko Yoshida; Lukas Bubendorf; Mauro Papotti; Giuseppe Pelosi; Fernando Lopez-Rios; Keiko Kunitoki; Dana Ferrari-Light; Lynette M Sholl; Mary Beth Beasley; Alain Borczuk; Johan Botling; Elisabeth Brambilla; Gang Chen; Teh-Ying Chou; Jin-Haeng Chung; Sanja Dacic; Deepali Jain; Fred R Hirsch; David Hwang; Sylvie Lantuejoul; Dongmei Lin; John W Longshore; Noriko Motoi; Masayuki Noguchi; Claudia Poleri; Natasha Rekhtman; Ming-Sound Tsao; Erik Thunnissen; William D Travis; Yasushi Yatabe; Anja C Roden; Jillian B Daigneault; Ignacio I Wistuba; Keith M Kerr; Harvey Pass; Andrew G Nicholson; Mari Mino-Kenudson Journal: J Thorac Oncol Date: 2020-06-17 Impact factor: 15.609
Authors: Katsura Emoto; Takashi Eguchi; Kay See Tan; Yusuke Takahashi; Rania G Aly; Natasha Rekhtman; William D Travis; Prasad S Adusumilli Journal: J Thorac Oncol Date: 2019-07-25 Impact factor: 15.609