한빛사논문
Joonseok Lee MD 1, Jae Hyun Jeon MD 1, Jin-Haeng Chung MD, PhD 2, Jung Woo Son MD 1, Beatrice Chia-Hui Shih MD 1, Woohyun Jung MD 1, Sukki Cho MD, PhD 1, Kwhanmien Kim MD, PhD 1, Sanghoon Jheon MD, PhD 1
1Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
2Department of Pathology and Translational Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
Corresponding author : Jae Hyun Jeon, MD
Abstract
Introduction: This study investigated the prognostic impact of non-predominant lepidic components in invasive non-mucinous adenocarcinoma.
Methods: Patients who underwent lobectomy and diagnosed with pathologic stage I non-mucinous, non-lepidic predominant invasive adenocarcinoma were included. Tumors were staged according to the eighth edition of TNM classification and categorized based on the presence of lepidic components in the final pathology. Overall survival (OS) and recurrence-free survival (RFS) were analyzed before and after applying inverse probability of treatment weighting. Competing risk analyses for recurrence were also compared between the two groups.
Results: Of the 1270 patients, 858 (67.6%) were lepidic (+). The pathologic stage and histologic grade were higher in the lepidic (-) group (P < .001, respectively). The 5-year OS and RFS were significantly worse in the lepidic (-) group than in the lepidic (+) group (OS: 88.2% versus 94.9%, P <.001; RFS: 79.4% versus 91.9%, P <.001). These trends were consistent after weighted analysis (OS: 92.4% versus 96.4%, P = 0.029; RFS: 85.6% versus 92.3%, P = 0.007). The 5-year cumulative incidence of any recurrence was 14.0% in the lepidic (-) group and 4.1% in the lepidic (+) group (P <.001). Multivariable Fine-gray regression analysis showed that the lepidic (+) group exhibited a lower risk of recurrence than the lepidic (-) group (HR 0.52, 95% CI 0.29-0.93, P = 0.031).
Conclusions: In pathologic stage I invasive non-mucinous adenocarcinoma, the presence of histologic non-predominant lepidic components might be associated with a better prognosis after curative surgery.
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