Which T1 lung cancers require "radical therapy"?_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SHI Wensong ¹ , HU Yuzhui ² , CHANG Guotao ¹ , ZENG Yanjie ¹ ,  YANG Yulun ¹ ,  ZHAO Xiaogang ³

1. Department of Thoracic Surgery, People’s Hospital of Zhengzhou, People’s Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, P.R.China;
2. Department of Respiratory Medicine, Affiliated Hospital of Guilin Medical University, Guilin, 541000, Guangxi, P.R.China;
3. Department of Thoracic Surgery, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai, 200433, P.R.China;

Corresponding author：

YANG Yulun, Email: hhyyl@126.com; ZHAO Xiaogang, Email: Xiaobenben20000cn@163.com

Keywords：

Stage T1 lung cancer; invasiveness; radical therapy; review

DOI：

10.7507/1007-4848.201911039

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Stage T1 lung cancer refers to the tumor with maximum diameter≤3 cm, surrounded by the pleural membrane of the lung or viscera, and does not exceed the lobar bronchus under the bronchoscope. The prognosis is generally good, but some of them are more invasive, and more aggressive treatments are needed to achieve the best prognosis. This article reviews which T1 lung cancers are susceptible to metastasis and their risk factors. It is hoped that such patients will receive the attention of relevant scholars, and when they are encountered clinically, a more aggressive approach will be taken to extend their life expectancy．

Citation： SHI Wensong, HU Yuzhui, CHANG Guotao, ZENG Yanjie, YANG Yulun, ZHAO Xiaogang. Which T1 lung cancers require "radical therapy"?. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(8): 965-971. doi: 10.7507/1007-4848.201911039 Copy

1.	National Lung Screening Trial Research Team, Aberle DR, Adams AM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 2011, 365(5): 395-409.
2.	Kobayashi Y, Mitsudomi T, Sakao Y, et al. Genetic features of pulmonary adenocarcinoma presenting with ground-glass nodules: the differences between nodules with and without growth. Ann Oncol, 2015, 26(1): 156-161.
3.	Izar B, Sequist L, Lee M, et al. The impact of EGFR mutation status on outcomes in patients with resected stage Ⅰ non-small cell lung cancers. Ann Thorac Surg, 2013, 96(3): 962-968.
4.	Xia Q, Zhu Z, Wang J, et al. Expression and association of HER2 with prognosis in early-stage (T1-T2N0M0) non-small cell lung cancer. Tumour Biol, 2012, 33(5): 1719-1725.
5.	Liang RB, Yang J, Zeng TS, et al. Incidence and distribution of lobe-specific mediastinal lymph node metastasis in non-small cell lung cancer: Data from 4511 resected cases. Ann Surg Oncol, 2018, 25(11): 3300-3307.
6.	Folch EE, Pritchett MA, Nead MA, et al. Electromagnetic navigation bronchoscopy for peripheral pulmonary lesions: One-year results of the prospective, multicenter NAVIGATE study. J Thorac Oncol, 2019, 14(3): 445-458.
7.	Makris D, Scherpereel A, Leroy S, et al. Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions. Eur Respir J, 2007, 29(6): 1187-1192.
8.	Gildea TR, Mazzone PJ, Karnak D, et al. Electromagnetic navigation diagnostic bronchoscopy: a prospective study. Am J Respir Crit Care Med, 2006, 174(9): 982-989.
9.	Yang F, Dong J, Wang X, et al. Non-small cell lung cancer: Spectral computed tomography quantitative parameters for preoperative diagnosis of metastatic lymph nodes. Eur J Radiol, 2017, 89: 129-135.
10.	Shimada Y, Kudo Y, Furumoto H, et al. Computed tomography histogram approach to predict lymph node metastasis in patients with clinical stage ⅠA lung cancer. Ann Thorac Surg, 2019, 108(4): 1021-1028.
11.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
12.	Cerfolio RJ, Bryant AS, Scott E, et al. Women with pathologic stage Ⅰ, Ⅱ, and Ⅲ non-small cell lung cancer have better survival than men. Chest, 2006, 130(6): 1796-1802.
13.	Radkiewicz C, Dickman PW, Johansson ALV, et al. Sex and survival in non-small cell lung cancer: A nationwide cohort study. PLoS One, 2019, 14(6): e0219206.
14.	Koike T, Koike T, Yamato Y, et al. Predictive risk factors for mediastinal lymph node metastasis in clinical stage ⅠA non-small-cell lung cancer patients. J Thorac Oncol, 2012, 7(8): 1246-1251.
15.	Chen B, Wang X, Yu X, et al. Lymph node metastasis in Chinese patients with clinical T1 non-small cell lung cancer: A multicenter real-world observational study. Thorac Cancer, 2019, 10(3): 533-542.
16.	Sacher AG, Dahlberg SE, Heng J, et al. Association between younger age and targetable genomic alterations and prognosis in non-small-cell lung cancer. JAMA Oncol, 2016, 2(3): 313-320.
17.	Chen YM, Lai CH, Rau KM, et al. Advanced non-small cell lung cancer patients at the extremes of age in the era of epidermal growth factor receptor tyrosine kinase inhibitors. Lung Cancer, 2016, 98: 99-105.
18.	Maeda R, Tomita M, Usuda K, et al. Clinicopathologic characteristics of non-small cell lung cancer in patients with smoking-related chronic obstructive pulmonary disease. Gen Thorac Cardiovasc Surg, 2019, 67(2): 239-246.
19.	Guo NL, Tosun K, Horn K. Impact and interactions between smoking and traditional prognostic factors in lung cancer progression. Lung Cancer, 2009, 66(3): 386-392.
20.	Chen W, Xia C, Zheng R, et al. Disparities by province, age, and sex in site-specific cancer burden attributable to 23 potentially modifiable risk factors in China: a comparative risk assessment. Lancet Glob Health, 2019, 7(2): e257-e269.
21.	Parsons A, Daley A, Begh R, et al. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ, 2010, 340: b5569.
22.	Haruki T, Aokage K, Miyoshi T, et al. Mediastinal nodal involvement in patients with clinical stage Ⅰ non-small-cell lung cancer: possibility of rational lymph node dissection. J Thorac Oncol, 2015, 10(6): 930-936.
23.	Sun W, Yang X, Liu Y, et al. Primary tumor location is a useful predictor for lymph node metastasis and prognosis in lung adenocarcinoma. Clin Lung Cancer, 2017, 18(1): e49-e55.
24.	Shi CL, Zhang XY, Han BH, et al. A clinicopathological study of resected non-small cell lung cancers 2 cm or less in diameter: a prognostic assessment. Med Oncol, 2011, 28(4): 1441-1446.
25.	Miyoshi T, Aokage K, Katsumata S, et al. Ground-glass opacity is a strong prognosticator for pathologic stage ⅠA lung adenocarcinoma. Ann Thorac Surg, 2019, 108(1): 249-255.
26.	Hattori A, Hirayama S, Matsunaga T, et al. Distinct clinicopathologic characteristics and prognosis based on the presence of ground glass opacity component in clinical stage ⅠA lung adenocarcinoma. J Thorac Oncol, 2019, 14(2): 265-275.
27.	Zhong C, Sakurai H, Wei S, et al. Sublobar resections for small-sized stage Ⅰa lung adenocarcinoma: a Sino-Japanese multicenter study. J Thorac Dis, 2018, 10(2): 991-998.
28.	Su H, Dai C, Xie H, et al. Risk factors of recurrence in patients with clinical stageⅠa adenocarcinoma presented as ground-glass nodule. Clin Lung Cancer, 2018, 19(5): e609-e617.
29.	Sawada S, Yamashita N, Sugimoto R, et al. Long-term outcomes of patients with ground-glass opacities detected using CT scanning. Chest, 2017, 151(2): 308-315.
30.	Ye B, Cheng M, Ge XX, et al. Factors that predict lymph node status in clinical stage T1aN0M0 lung adenocarcinomas. World J Surg Oncol, 2014, 12: 42.
31.	Ye T, Deng L, Wang S, et al. Lung adenocarcinomas manifesting as radiological part-solid nodules define a special clinical subtype. J Thorac Oncol, 2019, 14(4): 617-627.
32.	Wang L, Anraku M, Sato M, et al. Impact of the 8th edition of the UICC-TNM classification on clinical stage 0-ⅠA lung adenocarcinoma: does the new classification predict postoperative prognosis more precisely than the previous one? Ann Thorac Cardiovasc Surg, 2018, 24(5): 223-229.
33.	Chansky K, Detterbeck FC, Nicholson AG, et al. The IASLC lung cancer staging project: external validation of the revision of the TNM stage groupings in the eighth edition of the TNM classification of lung cancer. J Thorac Oncol, 2017, 12(7): 1109-1121.
34.	Ost D, Goldberg J, Rolnitzky L, et al. Survival after surgery in stage ⅠA and ⅠB non-small cell lung cancer. Am J Respir Crit Care Med, 2008, 177(5): 516-523.
35.	van Riel SJ, Sánchez CI, Bankier AA, et al. Observer variability for classification of pulmonary nodules on low-dose CT images and its effect on nodule management. Radiology, 2015, 277(3): 863-871.
36.	Seok Y, Yang HC, Kim TJ, et al. Frequency of lymph node metastasis according to the size of tumors in resected pulmonary adenocarcinoma with a size of 30 mm or smaller. J Thorac Oncol, 2014, 9(6): 818-824.
37.	Saji H, Matsubayashi J, Akata S, et al. Correlation between whole tumor size and solid component size on high-resolution computed tomography in the prediction of the degree of pathologic malignancy and the prognostic outcome in primary lung adenocarcinoma. Acta Radiol, 2015, 56(10): 1187-1195.
38.	Cho JY, Leem CS, Kim Y, et al. Solid part size is an important predictor of nodal metastasis in lung cancer with a subsolid tumor. BMC Pulm Med, 2018, 18(1): 151.
39.	Wang Z, Lu B, Sun L, et al. Identification of candidate genes or microRNAs associated with the lymph node metastasis of SCLC. Cancer Cell Int, 2018, 18: 161.
40.	Riihimäki M, Hemminki A, Fallah M, et al. Metastatic sites and survival in lung cancer. Lung Cancer, 2014, 86(1): 78-84.
41.	Ding N, Mao Y, Gao S, et al. Predictors of lymph node metastasis and possible selective lymph node dissection in clinical stage ⅠA non-small cell lung cancer. J Thorac Dis, 2018, 10(7): 4061-4068.
42.	Ruffini E, Asioli S, Filosso PL, et al. Significance of the presence of microscopic vascular invasion after complete resection of stage Ⅰ-Ⅱ pT1-T2N0 non-small cell lung cancer and its relation with T-size categories: did the 2009 7th edition of the TNM staging system miss something? J Thorac Oncol, 2011, 6(2): 319-326.
43.	Sperduto PW, Chao ST, Sneed PK, et al. Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4, 259 patients. Int J Radiat Oncol Biol Phys, 2010, 77(3): 655-661.
44.	Balekian AA, Fisher JM, Gould MK. Brain imaging for staging of patients with clinical stage ⅠA non-small cell lung cancer in the national lung screening trial: adherence with recommendations from the choosing wisely campaign. Chest, 2016, 149(4): 943-950.
45.	Ando T, Kage H, Saito M, et al. Early stage non-small cell lung cancer patients need brain imaging regardless of symptoms. Int J Clin Oncol, 2018, 23(4): 641-646.
46.	Rice SR, Molitoris JK, Vyfhuis MAL, et al. Lymph node size predicts for asymptomatic brain metastases in patients with non-small-cell lung cancer at diagnosis. Clin Lung Cancer, 2019, 20(1): e107-e114.
47.	Gaikwad A, Souza CA, Inacio JR, et al. Aerogenous metastases: a potential game changer in the diagnosis and management of primary lung adenocarcinoma. AJR Am J Roentgenol, 2014, 203(6): W570-W582.
48.	Uruga H, Fujii T, Fujimori S, et al. Semiquantitative assessment of tumor spread through air spaces (STAS) in early-stage lung adenocarcinomas. J Thorac Oncol, 2017, 12(7): 1046-1051.
49.	Warth A, Muley T, Kossakowski CA, et al. Prognostic impact of intra-alveolar tumor spread in pulmonary adenocarcinoma. Am J Surg Pathol, 2015, 39(6): 793-801.
50.	Yokoyama S, Murakami T, Tao H, et al. Tumor spread through air spaces identifies a distinct subgroup with poor prognosis in surgically resected lung pleomorphic carcinoma. Chest, 2018, 154(4): 838-847.
51.	Yi E, Bae MK, Cho S, et al. Pathological prognostic factors of recurrence in early stage lung adenocarcinoma. ANZ J Surg, 2018, 88(4): 327-331.
52.	Yanagawa N, Shiono S, Endo M, et al. Tumor spread through air spaces is a useful predictor of recurrence and prognosis in stage Ⅰ lung squamous cell carcinoma, but not in stage Ⅱ and Ⅲ. Lung Cancer, 2018, 120: 14-21.
53.	Eguchi T, Kameda K, Lu S, et al. Lobectomy is associated with better outcomes than sublobar resection in spread through air spaces (STAS)-positive T1 lung adenocarcinoma: a propensity score-matched analysis. J Thorac Oncol, 2019, 14(1): 87-98.
54.	Aly RG, Rekhtman N, Li X, et al. Spread through air spaces (STAS) is prognostic in atypical carcinoid, large cell neuroendocrine carcinoma, and small cell carcinoma of the lung. J Thorac Oncol, 2019, 14(9): 1583-1593.

1. National Lung Screening Trial Research Team, Aberle DR, Adams AM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 2011, 365(5): 395-409.
2. Kobayashi Y, Mitsudomi T, Sakao Y, et al. Genetic features of pulmonary adenocarcinoma presenting with ground-glass nodules: the differences between nodules with and without growth. Ann Oncol, 2015, 26(1): 156-161.
3. Izar B, Sequist L, Lee M, et al. The impact of EGFR mutation status on outcomes in patients with resected stage Ⅰ non-small cell lung cancers. Ann Thorac Surg, 2013, 96(3): 962-968.
4. Xia Q, Zhu Z, Wang J, et al. Expression and association of HER2 with prognosis in early-stage (T1-T2N0M0) non-small cell lung cancer. Tumour Biol, 2012, 33(5): 1719-1725.
5. Liang RB, Yang J, Zeng TS, et al. Incidence and distribution of lobe-specific mediastinal lymph node metastasis in non-small cell lung cancer: Data from 4511 resected cases. Ann Surg Oncol, 2018, 25(11): 3300-3307.
6. Folch EE, Pritchett MA, Nead MA, et al. Electromagnetic navigation bronchoscopy for peripheral pulmonary lesions: One-year results of the prospective, multicenter NAVIGATE study. J Thorac Oncol, 2019, 14(3): 445-458.
7. Makris D, Scherpereel A, Leroy S, et al. Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions. Eur Respir J, 2007, 29(6): 1187-1192.
8. Gildea TR, Mazzone PJ, Karnak D, et al. Electromagnetic navigation diagnostic bronchoscopy: a prospective study. Am J Respir Crit Care Med, 2006, 174(9): 982-989.
9. Yang F, Dong J, Wang X, et al. Non-small cell lung cancer: Spectral computed tomography quantitative parameters for preoperative diagnosis of metastatic lymph nodes. Eur J Radiol, 2017, 89: 129-135.
10. Shimada Y, Kudo Y, Furumoto H, et al. Computed tomography histogram approach to predict lymph node metastasis in patients with clinical stage ⅠA lung cancer. Ann Thorac Surg, 2019, 108(4): 1021-1028.
11. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
12. Cerfolio RJ, Bryant AS, Scott E, et al. Women with pathologic stage Ⅰ, Ⅱ, and Ⅲ non-small cell lung cancer have better survival than men. Chest, 2006, 130(6): 1796-1802.
13. Radkiewicz C, Dickman PW, Johansson ALV, et al. Sex and survival in non-small cell lung cancer: A nationwide cohort study. PLoS One, 2019, 14(6): e0219206.
14. Koike T, Koike T, Yamato Y, et al. Predictive risk factors for mediastinal lymph node metastasis in clinical stage ⅠA non-small-cell lung cancer patients. J Thorac Oncol, 2012, 7(8): 1246-1251.
15. Chen B, Wang X, Yu X, et al. Lymph node metastasis in Chinese patients with clinical T1 non-small cell lung cancer: A multicenter real-world observational study. Thorac Cancer, 2019, 10(3): 533-542.
16. Sacher AG, Dahlberg SE, Heng J, et al. Association between younger age and targetable genomic alterations and prognosis in non-small-cell lung cancer. JAMA Oncol, 2016, 2(3): 313-320.
17. Chen YM, Lai CH, Rau KM, et al. Advanced non-small cell lung cancer patients at the extremes of age in the era of epidermal growth factor receptor tyrosine kinase inhibitors. Lung Cancer, 2016, 98: 99-105.
18. Maeda R, Tomita M, Usuda K, et al. Clinicopathologic characteristics of non-small cell lung cancer in patients with smoking-related chronic obstructive pulmonary disease. Gen Thorac Cardiovasc Surg, 2019, 67(2): 239-246.
19. Guo NL, Tosun K, Horn K. Impact and interactions between smoking and traditional prognostic factors in lung cancer progression. Lung Cancer, 2009, 66(3): 386-392.
20. Chen W, Xia C, Zheng R, et al. Disparities by province, age, and sex in site-specific cancer burden attributable to 23 potentially modifiable risk factors in China: a comparative risk assessment. Lancet Glob Health, 2019, 7(2): e257-e269.
21. Parsons A, Daley A, Begh R, et al. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ, 2010, 340: b5569.
22. Haruki T, Aokage K, Miyoshi T, et al. Mediastinal nodal involvement in patients with clinical stage Ⅰ non-small-cell lung cancer: possibility of rational lymph node dissection. J Thorac Oncol, 2015, 10(6): 930-936.
23. Sun W, Yang X, Liu Y, et al. Primary tumor location is a useful predictor for lymph node metastasis and prognosis in lung adenocarcinoma. Clin Lung Cancer, 2017, 18(1): e49-e55.
24. Shi CL, Zhang XY, Han BH, et al. A clinicopathological study of resected non-small cell lung cancers 2 cm or less in diameter: a prognostic assessment. Med Oncol, 2011, 28(4): 1441-1446.
25. Miyoshi T, Aokage K, Katsumata S, et al. Ground-glass opacity is a strong prognosticator for pathologic stage ⅠA lung adenocarcinoma. Ann Thorac Surg, 2019, 108(1): 249-255.
26. Hattori A, Hirayama S, Matsunaga T, et al. Distinct clinicopathologic characteristics and prognosis based on the presence of ground glass opacity component in clinical stage ⅠA lung adenocarcinoma. J Thorac Oncol, 2019, 14(2): 265-275.
27. Zhong C, Sakurai H, Wei S, et al. Sublobar resections for small-sized stage Ⅰa lung adenocarcinoma: a Sino-Japanese multicenter study. J Thorac Dis, 2018, 10(2): 991-998.
28. Su H, Dai C, Xie H, et al. Risk factors of recurrence in patients with clinical stageⅠa adenocarcinoma presented as ground-glass nodule. Clin Lung Cancer, 2018, 19(5): e609-e617.
29. Sawada S, Yamashita N, Sugimoto R, et al. Long-term outcomes of patients with ground-glass opacities detected using CT scanning. Chest, 2017, 151(2): 308-315.
30. Ye B, Cheng M, Ge XX, et al. Factors that predict lymph node status in clinical stage T1aN0M0 lung adenocarcinomas. World J Surg Oncol, 2014, 12: 42.
31. Ye T, Deng L, Wang S, et al. Lung adenocarcinomas manifesting as radiological part-solid nodules define a special clinical subtype. J Thorac Oncol, 2019, 14(4): 617-627.
32. Wang L, Anraku M, Sato M, et al. Impact of the 8th edition of the UICC-TNM classification on clinical stage 0-ⅠA lung adenocarcinoma: does the new classification predict postoperative prognosis more precisely than the previous one? Ann Thorac Cardiovasc Surg, 2018, 24(5): 223-229.
33. Chansky K, Detterbeck FC, Nicholson AG, et al. The IASLC lung cancer staging project: external validation of the revision of the TNM stage groupings in the eighth edition of the TNM classification of lung cancer. J Thorac Oncol, 2017, 12(7): 1109-1121.
34. Ost D, Goldberg J, Rolnitzky L, et al. Survival after surgery in stage ⅠA and ⅠB non-small cell lung cancer. Am J Respir Crit Care Med, 2008, 177(5): 516-523.
35. van Riel SJ, Sánchez CI, Bankier AA, et al. Observer variability for classification of pulmonary nodules on low-dose CT images and its effect on nodule management. Radiology, 2015, 277(3): 863-871.
36. Seok Y, Yang HC, Kim TJ, et al. Frequency of lymph node metastasis according to the size of tumors in resected pulmonary adenocarcinoma with a size of 30 mm or smaller. J Thorac Oncol, 2014, 9(6): 818-824.
37. Saji H, Matsubayashi J, Akata S, et al. Correlation between whole tumor size and solid component size on high-resolution computed tomography in the prediction of the degree of pathologic malignancy and the prognostic outcome in primary lung adenocarcinoma. Acta Radiol, 2015, 56(10): 1187-1195.
38. Cho JY, Leem CS, Kim Y, et al. Solid part size is an important predictor of nodal metastasis in lung cancer with a subsolid tumor. BMC Pulm Med, 2018, 18(1): 151.
39. Wang Z, Lu B, Sun L, et al. Identification of candidate genes or microRNAs associated with the lymph node metastasis of SCLC. Cancer Cell Int, 2018, 18: 161.
40. Riihimäki M, Hemminki A, Fallah M, et al. Metastatic sites and survival in lung cancer. Lung Cancer, 2014, 86(1): 78-84.
41. Ding N, Mao Y, Gao S, et al. Predictors of lymph node metastasis and possible selective lymph node dissection in clinical stage ⅠA non-small cell lung cancer. J Thorac Dis, 2018, 10(7): 4061-4068.
42. Ruffini E, Asioli S, Filosso PL, et al. Significance of the presence of microscopic vascular invasion after complete resection of stage Ⅰ-Ⅱ pT1-T2N0 non-small cell lung cancer and its relation with T-size categories: did the 2009 7th edition of the TNM staging system miss something? J Thorac Oncol, 2011, 6(2): 319-326.
43. Sperduto PW, Chao ST, Sneed PK, et al. Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4, 259 patients. Int J Radiat Oncol Biol Phys, 2010, 77(3): 655-661.
44. Balekian AA, Fisher JM, Gould MK. Brain imaging for staging of patients with clinical stage ⅠA non-small cell lung cancer in the national lung screening trial: adherence with recommendations from the choosing wisely campaign. Chest, 2016, 149(4): 943-950.
45. Ando T, Kage H, Saito M, et al. Early stage non-small cell lung cancer patients need brain imaging regardless of symptoms. Int J Clin Oncol, 2018, 23(4): 641-646.
46. Rice SR, Molitoris JK, Vyfhuis MAL, et al. Lymph node size predicts for asymptomatic brain metastases in patients with non-small-cell lung cancer at diagnosis. Clin Lung Cancer, 2019, 20(1): e107-e114.
47. Gaikwad A, Souza CA, Inacio JR, et al. Aerogenous metastases: a potential game changer in the diagnosis and management of primary lung adenocarcinoma. AJR Am J Roentgenol, 2014, 203(6): W570-W582.
48. Uruga H, Fujii T, Fujimori S, et al. Semiquantitative assessment of tumor spread through air spaces (STAS) in early-stage lung adenocarcinomas. J Thorac Oncol, 2017, 12(7): 1046-1051.
49. Warth A, Muley T, Kossakowski CA, et al. Prognostic impact of intra-alveolar tumor spread in pulmonary adenocarcinoma. Am J Surg Pathol, 2015, 39(6): 793-801.
50. Yokoyama S, Murakami T, Tao H, et al. Tumor spread through air spaces identifies a distinct subgroup with poor prognosis in surgically resected lung pleomorphic carcinoma. Chest, 2018, 154(4): 838-847.
51. Yi E, Bae MK, Cho S, et al. Pathological prognostic factors of recurrence in early stage lung adenocarcinoma. ANZ J Surg, 2018, 88(4): 327-331.
52. Yanagawa N, Shiono S, Endo M, et al. Tumor spread through air spaces is a useful predictor of recurrence and prognosis in stage Ⅰ lung squamous cell carcinoma, but not in stage Ⅱ and Ⅲ. Lung Cancer, 2018, 120: 14-21.
53. Eguchi T, Kameda K, Lu S, et al. Lobectomy is associated with better outcomes than sublobar resection in spread through air spaces (STAS)-positive T1 lung adenocarcinoma: a propensity score-matched analysis. J Thorac Oncol, 2019, 14(1): 87-98.
54. Aly RG, Rekhtman N, Li X, et al. Spread through air spaces (STAS) is prognostic in atypical carcinoid, large cell neuroendocrine carcinoma, and small cell carcinoma of the lung. J Thorac Oncol, 2019, 14(9): 1583-1593.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Which T1 lung cancers require "radical therapy"?

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content