Prognostic Impact Of Tumor Spread Through Air Spaces In Non-Small Cell Lung Cancers

Surgical resection is the most effective treatment for early stage lung adenocarcinoma.However,the rate of 5-year postoperative recurrence reaches30%,Spread Through Air Spaces(STAS)is a recently described novel invasive pattern of lung cancer,According to the 2015 WHO classification.STAS is defined as micropapillary clusters,solid nests,or single cells spreading within air spaces beyond the edge of the main tumor,However,the prognostic role of STAS in lung cancer is not clear,The aim of the current study is to assess the association between STAS and clinical outcome of lung cancer patients after surgical resection through a meta-analysis.Systematic research was conducted using three online databases to search for studies published before Dec 31,2020.The Recurrence-free survival(RFS)and Overall survival(OS)for non-small cell lung cancer patients after surgical resection with or without STAS were compared.The studies were selected according to rigorous inclusion and exclusion criteria.Meta-analysis was performed using hazard ratio(HR)and 95% confidence intervals(CIs)as effective measures.Included in our meta-analysis were 12 studies,published from 2015 to 2018,with a total of 3,564 patients.Our results clearly revealed that the presence of STAS predicted a worse outcome for RFS with the combined HR of 1.84(95% CI: 1.59–2.12).Meta-analysis of these 8 studies showed that patients with the presence of STAS were associated with shorter OS(the pooled HR:1.78,95% CI: 1.51– 2.11).This meta-analysis described that the presence of STAS might be a unfavorable prognostic factor for patients with NSCLC.it should be paid sufficient attention and recorded in pathologic reports,which can indicate treatment choice and prognosis of patients.