Lung adenocarcinoma with micropapillary and solid patterns: Recurrence rate and trends

Area of Science:

• Oncology
• Thoracic Surgery
• Pathology

Background:

• Lung adenocarcinoma with micropapillary pattern (MP) or solid pattern (SP) is associated with poor prognosis and frequent recurrence.
• Established treatment strategies for these specific histological subtypes are lacking.
• This study investigates recurrence patterns and rates in lung adenocarcinoma patients with MP or SP.

Purpose of the Study:

• To compare recurrence rates and patterns between lung adenocarcinoma patients with and without micropapillary (MP) or solid pattern (SP).
• To identify prognostic factors associated with recurrence in these histological subtypes.
• To inform potential treatment strategies for early-stage lung adenocarcinoma with MP or SP.

Main Methods:

• Retrospective analysis of 238 lung adenocarcinoma patients undergoing radical resection.
• Classification into three groups: neither MP nor SP (MP-/SP-), MP (MP+), and SP (SP+).
• Evaluation of clinical/pathological characteristics, recurrence-free survival (RFS), recurrence sites, PD-L1 expression, and driver mutations.

Main Results:

• Significantly higher recurrence rates and shorter RFS were observed in MP+ and SP+ groups compared to MP-/SP-.
• Micropapillary pattern (MP) was an independent predictor of recurrence in multivariate analysis.
• Distant metastases were the predominant recurrence pattern in MP+ and SP+ groups; PD-L1 was highly expressed in recurrent SP+ cases.

Conclusions:

• Early-stage lung adenocarcinoma with MP or SP exhibits a high risk of postoperative recurrence.
• Focusing on the prevention of distant metastases is critical for improving patient prognosis.
• Consideration of aggressive postoperative chemotherapy may be warranted for patients with these histological subtypes.