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The prognostic impact of extra-alveolar invasion in lung adenocarcinoma

  • 0Department of Pathology, the University of Tokyo, Tokyo, Japan.
Lung +

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June 4, 2025

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June 4, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Extra-alveolar invasion (EX) is a significant prognostic factor in lung adenocarcinoma, impacting recurrence-free survival. Understanding invasion depth is crucial for accurate lung cancer staging and prognosis.

Area Of Science

  • Pulmonary Pathology
  • Surgical Oncology
  • Cancer Prognostics

Background

  • Lung cancer prognosis research often focuses on histological patterns like spread through air spaces (STAS) and grading.
  • Anatomical depth of invasion in lung cancer remains underexplored for prognostic significance.
  • Current lung cancer staging primarily considers invasion of visceral pleura and main bronchus.

Purpose Of The Study

  • To investigate the prognostic impact of extra-alveolar invasion (EX) in non-mucinous lung adenocarcinoma.
  • To determine if EX is an independent prognostic factor for recurrence-free survival (RFS).
  • To compare the prognostic value of EX with existing factors like STAS and histological grading.

Main Methods

  • Classification of lung tissues into alveolar and extra-alveolar regions.
  • Analysis of 178 non-mucinous lung adenocarcinoma cases undergoing complete resection.
  • Definition of EX as periarterial, peribronchial/peribronchiolar, or interlobular septal invasion.

Main Results

  • All three types of extra-alveolar invasion (EX) were associated with poor prognosis.
  • EX was identified as an independent prognostic factor for recurrence-free survival (RFS).
  • Patients with pT1 stage and EX invasion showed significantly shorter RFS, comparable to pT2 stage, while pT1 EX(-) patients had no recurrence.

Conclusions

  • Extra-alveolar invasion (EX) is a critical independent prognostic factor in non-mucinous lung adenocarcinoma.
  • The depth of invasion, specifically EX, holds significant prognostic value.
  • Further research is warranted to evaluate the incorporation of EX into future pathological T staging classifications.

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