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Comparison between sub-lobar resection and lobar resection for clinical stage IA (tumor size ≤ 2 cm) lung invasive mucinous adenocarcinoma with tumor spread through air spaces: A multi-center real-world study

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Pubmed体系：
作者：
Pan Hanbo[1] * ; Kong Weicheng[2] * ; Yin Hui[3] * ; Shen Yaofeng[4] * ; Chen Hang[5] ; Ge Zhen[6] ; Li Wanyu[7] ; Zhang Jiaqi[1] ; Tian Yu[1] ; Ning Junwei[1,8] ; Fang Liang[1,3] ; Dai Zhizhuo[9] ; Zheng Min[8] ; Chen Zhongjie[10] ; Ruan Guomo[11] ; Li Ziming[12] ; Zhang Ming[7] ; Zhou Chengwei[6] ; Xu Guodong[5] ; Huang Jia[1] ; Hu Yingjie[1] ; Luo Qingquan[1] ;
机构： [1]Department of Thoracic Surgical Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China [2]Department of Thoracic Surgery, Zhoushan Putuo District People’s Hospital, Zhoushan, China [3]Department of Thoracic Surgery, The First Affiliated Hospital of Shaoyang University, Shaoyang, China [4]Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China [5]Department of Cardiothoracic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China [6]Department of Cardiothoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, China [7]Department of Integrated Traditional Chinese and Western Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China [8]Department of Thoracic Surgery, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China [9]School of Life Science and Technology, ShanghaiTech University, Shanghai, China [10]Department of Cardiothoracic Surgery, Ningbo Beilun District People’s Hospital, Ningbo, China [11]Wenzhou People’s Hospital, Shanghai University, Wenzhou, China [12]Department of Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
出处：
DOI： 10.1016/j.ejso.2025.110364
ISSN：

关键词： Lung invasive mucinous adenocarcinoma Spread through air spaces Sub-lobar resection Lobar resection Overall survival

摘要：
Tumor spread through air spaces (STAS) has emerged as a significant prognostic factor in clinical stage IA (cIA) invasive mucinous adenocarcinoma (IMA) of the lung. However, it remains unclear whether sub-lobar resection (SR) offers survival outcomes comparable to those of lobar resection (LR) in this cohort. This study aimed to assess the efficacy of SR in patients with STAS-positive cIA (tumor size ≤2 cm) IMA using large-scale, multi-center, real-world data.We retrospectively reviewed consecutive patients with peripheral cIA (≤2 cm) STAS-positive IMA who underwent SR or LR between 2012 and 2020 at seven high-volume institutions across five Chinese cities. The primary endpoint was overall survival (OS), and the secondary endpoint was recurrence-free survival (RFS). Propensity-score matching (PSM) was employed to mitigate selection bias.Among 567 included patients, PSM yielded 179 patients undergoing SR and 388 patients undergoing LR. Over a median follow-up of 6.2 years, SR demonstrated comparable 5-year OS (78.7 % versus 81.6 %, hazard ratio (HR) = 0.976, 95 % confidence interval (CI) = 0.693-1.375, P = 0.890) and RFS (69.0 % versus 71.8 %, HR = 1.017, 95 %CI = 0.752-1.376, P = 0.914) to LR. Subgroup analysis revealed that SR improved 5-year OS in patients aged ≥70 years (73.1 % versus 67.2 %, HR = 0.636, 95 %CI = 0.404-0.969, P = 0.040). Additionally, SR yielded similar outcomes in patients with visceral pleural invasion and exhibited a statistically nonsignificant trend toward lower survival in those with pathological N1-2 disease. Furthermore, LR, segmentectomy, and wedge resection yielded comparable 5-year OS and RFS.Among patients with cIA (≤2 cm) STAS-positive IMA, SR provides 5-year OS and RFS outcomes comparable to LR and may confer a survival advantage among patients aged ≥70 years. These findings support the efficacy of SR and suggest that it should not be considered an adverse prognostic factor in this patient cohort.Copyright © 2025 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

基金：
the National Nature Science Foundation of China (82473210), Natural Science Foundation of Shanghai (24ZR1464400), Development Center for Medical Science & Technology National Health Commission of the People’s Republic of China(WA2021RW27), and Zhejiang Province Medical and Health Project (2022KY296).
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外文
PubmedID：
中科院(CAS)分区：
出版当年[2025]版：
大类 | 2 区 医学
小类 | 2 区 肿瘤学 2 区 外科
最新[2025]版：
大类 | 2 区 医学
小类 | 2 区 肿瘤学 2 区 外科
第一作者：
第一作者机构： [1]Department of Thoracic Surgical Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Pan Hanbo,Kong Weicheng,Yin Hui,et al.Comparison between sub-lobar resection and lobar resection for clinical stage IA (tumor size ≤ 2 cm) lung invasive mucinous adenocarcinoma with tumor spread through air spaces: A multi-center real-world study[J].European Journal Of Surgical Oncology : The Journal Of The European Society Of Surgical Oncology And The British Association Of Surgical Oncology.2025,51(10):110364.doi:10.1016/j.ejso.2025.110364.
APA：
Pan Hanbo,Kong Weicheng,Yin Hui,Shen Yaofeng,Chen Hang...&Luo Qingquan.(2025).Comparison between sub-lobar resection and lobar resection for clinical stage IA (tumor size ≤ 2 cm) lung invasive mucinous adenocarcinoma with tumor spread through air spaces: A multi-center real-world study.European Journal Of Surgical Oncology : The Journal Of The European Society Of Surgical Oncology And The British Association Of Surgical Oncology,51,(10)
MLA：
Pan Hanbo,et al."Comparison between sub-lobar resection and lobar resection for clinical stage IA (tumor size ≤ 2 cm) lung invasive mucinous adenocarcinoma with tumor spread through air spaces: A multi-center real-world study".European Journal Of Surgical Oncology : The Journal Of The European Society Of Surgical Oncology And The British Association Of Surgical Oncology 51..10(2025):110364

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