Prognostic value of spread through air spaces in operated lung squamous cell carcinoma patients: A meta-analysis

The presence of spread through air spaces (STAS) predicts poor long-term survival of lung cancer patients. However, the association between STAS and prognosis of operated lung squamous cell carcinoma (LSCC) remains unclear at this time. The aim of this meta-analysis was to further identify the prognostic value of STAS in surgical LSCC patients.

Several electronic databases were searched up to April 12, 2025 for relevant studies. The primary and secondary outcomes were progression-free survival and overall survival/cancer-specific survival, respectively. The hazard ratios (HRs) and 95% confidence intervals (CIs) were combined and all statistical analyses were conducted by STATA 15.0 software.

A total of 9 studies involving 2884 cases were included and reviewed. The pooled results demonstrated that the presence of STAS was significantly associated with poor progression-free survival (HR = 1.84, 95% CI: 1.57-2.16, P< .001). Besides, STAS predicted poorer overall survival (HR = 1.75, 95% CI: 1.23-2.51, P = .002) and cancer-specific survival (HR = 1.73, 95% CI: 1.33-2.26, P < .001) in surgical LSCC.

Based on current evidence, STAS was identified as a novel and valuable prognostic risk factor for operated LSCC patients. However, more prospective high-quality studies are still needed to verify above findings.