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Prognostic impact of lung adenocarcinoma second predominant pattern from a large European database
Author(s) -
Bertoglio Pietro,
Querzoli Giulia,
Ventura Luigi,
Aprile Vittorio,
Cattoni Maria A.,
Nachira Dania,
Lococo Filippo,
Rodriguez Perez Maria,
Guerrera Francesco,
Minervini Fabrizio,
Gnetti Letizia,
Bacchin Diana,
Franzi Francesca,
Rindi Guido,
Bellafiore Salvatore,
Femia Federico,
Viti Andrea,
Bogina Giuseppe S.,
Kestenholz Peter,
Ruffini Enrico,
Paci Massimiliano,
Margaritora Stefano,
Imperatori Andrea S.,
Lucchi Marco,
Ampollini Luca,
Terzi Alberto C.
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26292
Subject(s) - medicine , lymphadenectomy , adenocarcinoma , pathological , lymph node , lung , stage (stratigraphy) , homogeneous , oncology , gastroenterology , pathology , cancer , biology , paleontology , physics , thermodynamics
Background and Objectives Adenocarcinoma patterns could be grouped based on clinical behaviors: low‐ (lepidic), intermediate‐ (papillary or acinar), and high‐grade (micropapillary and solid). We analyzed the impact of the second predominant pattern (SPP) on disease‐free survival (DFS). Methods We retrospectively collected data of surgically resected stage I and II adenocarcinoma. Selection criteria: anatomical resection with lymphadenectomy and pathological N0. Pure adenocarcinomas and mucinous subtypes were excluded. Recurrence rate and factors affecting DFS were analyzed according to the SPP focusing on intermediate‐grade predominant pattern adenocarcinomas. Results Among 270 patients, 55% were male. The mean age was 68.3 years. SPP pattern appeared as follows: lepidic 43.0%, papillary 23.0%, solid 14.4%, acinar 11.9%, and micropapillary 7.8%. The recurrence rate was 21.5% and 5‐year DFS was 71.1%. No difference in DFS was found according to SPP ( p = .522). In patients with high‐grade SPP, the percentage of SPP, age, and tumor size significantly influenced DFS ( p = .016). In patients with lepidic SPP, size, male gender, and lymph‐node sampling ( p = .005; p = .014; p = .038, respectively) significantly influenced DFS. Conclusions The impact of SPP on DFS is not homogeneous in a subset of patients with the intermediate‐grade predominant patterns. The influence of high‐grade SPP on DFS is related to its proportion in the tumor.