Procedure-Specific Risk Prediction for Recurrence in Patients Undergoing Lobectomy or Sublobar Resection for Small (≤2 cm) Lung Adenocarcinoma: An International Cohort Analysis.
Adjuvant chemotherapy
Competing risks analysis
Lung cancer–specific death
Recurrence
Sublobar resection
Journal
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
ISSN: 1556-1380
Titre abrégé: J Thorac Oncol
Pays: United States
ID NLM: 101274235
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
02
07
2018
revised:
23
08
2018
accepted:
16
09
2018
pubmed:
27
9
2018
medline:
22
4
2020
entrez:
27
9
2018
Statut:
ppublish
Résumé
This work was performed to develop and validate procedure-specific risk prediction for recurrence following resection for early-stage lung adenocarcinoma (ADC) and investigate risk prediction utility in identifying patients who may benefit from adjuvant chemotherapy (ACT). In patients who underwent resection for small (≤2 cm) lung ADC (lobectomy, 557; sublobar resection, 352), an association between clinicopathologic variables and risk of recurrence was assessed by a competing risks approach. Procedure-specific risk prediction was developed based on multivariable regression for recurrence. External validation was conducted using cohorts (N = 708) from Japan, Taiwan, and Germany. The accuracy of risk prediction was measured using a concordance index. We applied the lobectomy risk prediction approach to a propensity score-matched cohort of patients with stage II-III disease (n = 316, after matching) with or without ACT and compared lung cancer-specific survival between groups among low- or high-risk scores. Micropapillary pattern, solid pattern, lymphovascular invasion, and necrosis were involved in the risk prediction following lobectomy, and micropapillary pattern, spread through air spaces, lymphovascular invasion, and necrosis following sublobar resection. Both internal and external validation showed good discrimination (concordance index in lobectomy and sublobar resection: internal, 0.77 and 0.75, respectively; and external, 0.73 and 0.79, respectively). In the stage II-III propensity score-matched cohort, among high-risk patients, ACT significantly reduced the risk of lung cancer-specific death (subhazard ratio 0.43, p = 0.001), but not among low-risk patients. Procedure-specific risk prediction for patients with resected small lung ADC can be used to better prognosticate and stratify patients for further interventions.
Identifiants
pubmed: 30253972
pii: S1556-0864(18)33119-8
doi: 10.1016/j.jtho.2018.09.008
pmc: PMC6309652
mid: NIHMS1512762
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
72-86Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA217169
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA236615
Pays : United States
Informations de copyright
Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
Références
Ann Surg Oncol. 2015 Nov;22(12):4089-97
pubmed: 25783676
Stat Med. 2009 Nov 10;28(25):3083-107
pubmed: 19757444
Clin Cancer Res. 2012 Apr 15;18(8):2301-8
pubmed: 22282466
J Natl Cancer Inst. 2013 Aug 21;105(16):1212-20
pubmed: 23926067
Oncotarget. 2017 Dec 28;9(7):7272-7273
pubmed: 29484108
J Clin Oncol. 2015 Oct 20;33(30):3439-46
pubmed: 25918286
J Thorac Cardiovasc Surg. 2014 Mar;147(3):921-928.e2
pubmed: 24199757
J Clin Oncol. 2017 Sep 1;35(25):2960-2974
pubmed: 28437162
Chest. 2013 May;143(5):1365-1377
pubmed: 23715196
J Thorac Oncol. 2015 Apr;10(4):682-90
pubmed: 25590605
J Clin Oncol. 2016 Apr 10;34(11):1270-7
pubmed: 26884579
Pharm Stat. 2011 Mar-Apr;10(2):150-61
pubmed: 20925139
N Engl J Med. 2011 Aug 4;365(5):395-409
pubmed: 21714641
Radiology. 2016 Dec;281(3):947-957
pubmed: 27347764
Pathol Int. 2016 Jan;66(1):1-7
pubmed: 26642845
Eur Radiol. 2016 Jun;26(6):1538-46
pubmed: 26455720
J Thorac Cardiovasc Surg. 2003 Apr;125(4):924-8
pubmed: 12698157
J Thorac Cardiovasc Surg. 2010 Feb;139(2):366-78
pubmed: 20106398
Am J Surg Pathol. 2003 Jan;27(1):101-9
pubmed: 12502932
Ann Thorac Surg. 2011 Nov;92(5):1819-23; discussion 1824-5
pubmed: 22051277
J Cancer Res Clin Oncol. 2017 Jun;143(6):1043-1051
pubmed: 28204972
Ann Thorac Surg. 2016 Jul;102(1):239-46
pubmed: 27101729
J Clin Oncol. 2015 Mar 10;33(8):861-9
pubmed: 25624438
Mod Pathol. 2011 May;24(5):653-64
pubmed: 21252858
Am J Surg Pathol. 2015 Jun;39(6):793-801
pubmed: 25723114
J Clin Oncol. 2017 Jan 20;35(3):281-290
pubmed: 28095268
J Thorac Oncol. 2015 May;10(5):806-814
pubmed: 25629637
J Clin Oncol. 2015 Sep 10;33(26):2877-84
pubmed: 26261257
J Clin Oncol. 2007 Dec 1;25(34):5506-18
pubmed: 17954710
J Thorac Oncol. 2015 Dec;10(12):1785-94
pubmed: 26473646
Multivariate Behav Res. 2011 May;46(3):399-424
pubmed: 21818162
J Clin Oncol. 2012 May 1;30(13):1438-46
pubmed: 22393100
J Thorac Cardiovasc Surg. 2014 Oct;148(4):1193-9
pubmed: 24667022
J Clin Oncol. 2008 Mar 10;26(8):1364-70
pubmed: 18323559
Ann Surg Oncol. 2017 Jun;24(6):1459-1464
pubmed: 28168388
Stat Med. 1989 May;8(5):551-61
pubmed: 2657958
J Thorac Oncol. 2011 Feb;6(2):244-85
pubmed: 21252716
J Clin Oncol. 2014 Aug 1;32(22):2357-64
pubmed: 24799473
Ann Thorac Surg. 1995 Sep;60(3):615-22; discussion 622-3
pubmed: 7677489
J Thorac Oncol. 2015 Sep;10(9):1243-1260
pubmed: 26291008
J Exp Clin Cancer Res. 2017 Jan 5;36(1):4
pubmed: 28057025
J Thorac Oncol. 2015 Jul;10(7):990-1003
pubmed: 26134221