Abstract
Objective
This study aimed to reveal the long-term outcomes of patients with lung cancer with
adenocarcinoma in situ or minimally invasive adenocarcinoma after resection, in the
context of the different surgical resection types.
Methods
Patients with lung adenocarcinoma who underwent resection between December 2007 and
December 2012 were reviewed. Patients with pathological adenocarcinoma in situ or
minimally invasive adenocarcinoma were enrolled. Postoperative survival and risk of
developing second primary lung cancer were analyzed.
Results
After reevaluating the histological findings of 1696 patients with lung adenocarcinoma,
we enrolled 53 with adenocarcinoma in situ and 72 with minimally invasive adenocarcinoma
for analyses. Of all 125 patients with adenocarcinoma in situ/minimally invasive adenocarcinoma,
86 (68.8%) were female, 114 (91.2%) were nonsmokers, and most of them (78, 62.4%)
underwent wedge resection. The median follow-up period after surgery was 111 months.
The 10-year recurrence-free survivals of adenocarcinoma in situ and minimally invasive
adenocarcinoma were all 100%, and the 10-year overall survivals of adenocarcinoma
in situ and minimally invasive adenocarcinoma were 98.1% and 97.2%, respectively.
There was no difference in 10-year recurrence-free survival between patients who underwent
lobectomy and wedge resection. EGFR mutations were detected in 63.1% (41/65) of patients who underwent mutational analysis.
The risks of developing second primary lung cancer for adenocarcinoma in situ and
minimally invasive adenocarcinoma 10 years after resection were 8.4% and 4.3% (P = .298), respectively, and were not correlated with EGFR mutation status (P = .525).
Conclusions
Pathological adenocarcinoma in situ and minimally invasive adenocarcinoma have no
recurrence during 10-year follow-up after resection, regardless of surgical procedure
types. Surgery is curative for these patients, and wedge resection is the preferred
surgical procedure for nodules in the proper location.
Video Abstract
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Graphical Abstract
Key Words
Abbreviations and Acronyms:
AIS (adenocarcinoma in situ), CI (confidence interval), CT (computed tomography), GGO (ground-glass opacity), IAC (invasive lung adenocarcinoma), MIA (minimally invasive adenocarcinoma), OS (overall survival), RFS (recurrence-free survival), SPLC (secondary primary lung cancer)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 04, 2022
Accepted:
June 28,
2022
Received in revised form:
June 9,
2022
Received:
March 4,
2022
Footnotes
This work was supported by the National Natural Science Foundation of China (81930073, 81972171, 82102914), Shanghai Technology Innovation Action Project (20JC1417200), Shanghai Rising-Star Program (21QC1400600), and Shanghai Anticancer Association EYAS PROJECT (SACA-CY21B07).
This study was conducted in accordance with the amended Declaration of Helsinki and was approved by the Ethics Committee and Institutional Review Boards of Fudan University Shanghai Cancer Center (IRB2008223-9, Date: July 14, 2020), and all patients were exempt from informed consent because of the minimal risks of the study.
Drs Li and Deng contributed equally to this work. Drs Chen, Zhang, and Li contributed equally as co-senior authors.
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© 2022 by The American Association for Thoracic Surgery
