Prognostic importance of tumor spread through air spaces in lymph node negative operated adenocarcinoma lung cancers

Abstract

Background: STAS (Spread through air spaces) defined as spreading of tumor cells to the adjacent pulmonary parenchyma by using air spaces, is a new invasion indicator adenocarcinoma lung cancers. In our study we aim to investigate relation between survey and lymph node existence as considering STAS. Method: We evaluate the adenocarcinoma lung cancer patients had lobectomized or pneumonectomized in American Hospital and Koc University Hospital between 2000 -2016. Locally advanced cases and patients some may be prognostic positive factors other than STAS didn't considered. According to these criteria totally 171 patients counted in our study. STAS existence statistically analyzed in terms of lymph node metastasis and survey relation. In survey analysis we examined the data of patients had operated before November 2011, owing to significance of follow up time. Result: 103 of 171 patients were men (60,2%) and 68 of them were women (39,8%). Characteristic specialties and dermographic data of them has demonstrated in 1st chart. Lymph node invasion (N1-N2) and alveolar spread togetherness was in statistically significant ratio comparing with the cases who hasn't alveolar spread (38.33% vs 24.32% p: 0.05) When in last 5 years operated patients were excluded from study, 66 left. And 42 of them were men (63.6%), 24 of them were women (36.4%) Mean age were 61.82/+-10.26 (36-84). Mean follow up time has detected as 58.98 months. Average survey was 71.47 months in patients has alveolar spread and 79.8 months at patients who haven't. There weren't statistically significant difference between these two groups (p=0.66) When we analyzed survey of lymph node negative cases, we detected patients with alveolar spread had statistically worse survey (62.53 months versus 90.63 months, p=0.05). Conclusion: Instead of sublober rejections in lymph node negative patients with alveolar spread, low survey and high recurrence probability must be considered while to approach lober rejections. And in only STAS existence even if lymph nodes are negative, adjuvant therapy is recommended.