Clinical, Imaging, and Pathological-Molecular Characteristics Associated with Stage IA Invasive Lung Adenocarcinoma Recurrence After Sub-lobar Resection

Xin Fan ¹, Chen Liang ², Xueqin Ma ³

⁰Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (X.F., Q.L.).

Academic Radiology +

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July 23, 2024

View abstract on PubMed

Summary

Clinical and CT scan features predict prognosis in stage IA lung adenocarcinoma patients after sub-lobar resection. These factors, along with pathological-molecular markers, aid in personalized treatment decisions for improved patient outcomes.

Area Of Science

Oncology
Radiology
Pathology

Background

Stage IA invasive lung adenocarcinoma (ILADC) prognosis after sub-lobar resection can be variable.
Identifying predictive factors is crucial for tailoring treatment strategies.

Purpose Of The Study

To investigate the association of clinical, imaging, and pathological-molecular characteristics with patient prognosis in stage IA ILADC.
To identify independent risk factors for recurrence after sub-lobar resection.

Main Methods

A retrospective study of 360 stage IA ILADC patients undergoing sub-lobar resection.
Analysis of clinical data, preoperative chest CT scans, histological subtypes, and gene mutation status.
Binary logistic regression and external validation using a 113-patient cohort.

Main Results

Old age, male gender, smoking, and high comorbidity index were associated with recurrence.
CT features like large tumor size, solid-predominant density, spiculation, and pleural abnormalities predicted recurrence (AUC=0.942, validation AUC=0.958).
Recurrent patients showed micropapillary/solid patterns and KRAS/ALK/NRAS mutations, while non-recurrent patients had more EGFR mutations.

Conclusions

Clinical and CT features are valuable for predicting prognosis in stage IA ILADC patients post-sub-lobar resection.
Pathological-molecular features also differ between recurrent and non-recurrent groups.
These findings support individualized treatment planning for stage IA ILADC.

Keywords:

Computed tomography Gene mutation status Lung cancer Sub-lobar resection