European Journal of Cardio-Thoracic Surgery Advance Access published March 11, 2015
ORIGINAL ARTICLE
European Journal of Cardio-Thoracic Surgery (2015) 1–7 doi:10.1093/ejcts/ezv058
Negative prognostic influence of micropapillary pattern in stage IA lung adenocarcinoma Norifumi Tsubokawaa, Takahiro Mimaea, Shinsuke Sasadaa, Tomoharu Yoshiyaa, Takeshi Mimuraa, Shuji Murakamib, Hiroyuki Itoc, Yoshihiro Miyataa, Haruhiko Nakayamac and Morihito Okadaa,* a b c
Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan Department of Respiratory Medicine, Kanagawa Cancer Center, Yokohama, Japan Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan
* Corresponding author. Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. Tel: +81-82-2575869; Fax: +81-82-2567109; e-mail: [email protected]; [email protected] (M. Okada) Received 14 November 2014; received in revised form 20 January 2015; accepted 23 January 2015
Abstract OBJECTIVES: There is uncertainty as to which factors determine the aggressiveness of lung adenocarcinoma with a micropapillary pattern (MPP). The present study aimed to clarify the influence of a MPP on the malignant aggressiveness of clinical stage IA lung adenocarcinoma. METHODS: We retrospectively examined 347 consecutive patients with clinical stage IA lung adenocarcinoma who underwent complete resection. We defined MPP-positive as accounting for ≥5% of the entire tumour. RESULTS: Forty-eight (14%) and 299 (86%) patients were MPP-positive and negative, respectively. Lymphatic (P = 0.003) and vessel (P = 0.029) invasion as well as lymph node metastasis (P = 0.002) were more frequent in the MPP-positive than negative group. Five-year disease-free survival (DFS) rates were significantly lower in the MPP-positive than negative group (69.7 vs 89.3%, P < 0.001). Multivariate analysis for DFS showed that MPP (P = 0.048), lymphatic invasion (P = 0.003) and vessel invasion (P = 0.002) were independent poor prognostic factors. In addition, higher proportions (
ORIGINAL ARTICLE
European Journal of Cardio-Thoracic Surgery (2015) 1–7 doi:10.1093/ejcts/ezv058
Negative prognostic influence of micropapillary pattern in stage IA lung adenocarcinoma Norifumi Tsubokawaa, Takahiro Mimaea, Shinsuke Sasadaa, Tomoharu Yoshiyaa, Takeshi Mimuraa, Shuji Murakamib, Hiroyuki Itoc, Yoshihiro Miyataa, Haruhiko Nakayamac and Morihito Okadaa,* a b c
Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan Department of Respiratory Medicine, Kanagawa Cancer Center, Yokohama, Japan Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan
* Corresponding author. Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. Tel: +81-82-2575869; Fax: +81-82-2567109; e-mail: [email protected]; [email protected] (M. Okada) Received 14 November 2014; received in revised form 20 January 2015; accepted 23 January 2015
Abstract OBJECTIVES: There is uncertainty as to which factors determine the aggressiveness of lung adenocarcinoma with a micropapillary pattern (MPP). The present study aimed to clarify the influence of a MPP on the malignant aggressiveness of clinical stage IA lung adenocarcinoma. METHODS: We retrospectively examined 347 consecutive patients with clinical stage IA lung adenocarcinoma who underwent complete resection. We defined MPP-positive as accounting for ≥5% of the entire tumour. RESULTS: Forty-eight (14%) and 299 (86%) patients were MPP-positive and negative, respectively. Lymphatic (P = 0.003) and vessel (P = 0.029) invasion as well as lymph node metastasis (P = 0.002) were more frequent in the MPP-positive than negative group. Five-year disease-free survival (DFS) rates were significantly lower in the MPP-positive than negative group (69.7 vs 89.3%, P < 0.001). Multivariate analysis for DFS showed that MPP (P = 0.048), lymphatic invasion (P = 0.003) and vessel invasion (P = 0.002) were independent poor prognostic factors. In addition, higher proportions (
