Clinical and pathological factors in pathologic stage IA lung adenocarcinoma: relevance of the micropapillary pattern and tumor necrosis

Abstract

Introduction: The objective was to investigate and correlate clinical and morphological lung adenocarcinoma factors with clinical results in patients treated with surgery in pathological stage IA.

            Methodology: An observational, analytical and retrospective study of patients diagnosed with pathological stage IA pulmonary adenocarcinoma was performed and the clinical and pathological variables were analyzed using disease-free survival (DFS) and cancer-specific survival (CSS), in a univariate and multivariate study.

            Results: 77.3% of men were found, with an average age of 61.6 (SD 8.5) and 83.2% of smokers and ex-smokers. 93.3% of the patients underwent lobectomy with lymphadenectomy. The mean total tumor size was 21.9mm (SD 6.4) and the size of the invasion was 16.9mm (SD 9.4). The most frequent histological pattern was acinar and the least frequent was micropapillary. A total of 28.6% of patients with tumor recurrence were found, which were distant metastases in 70.6%. The DFS and CSS at 5 years was 74.9% and 82.7% respectively. Clinical-pathological variables were analyzed as prognostic factors in a multivariable model for DFS and CSS. The micropapillary component obtained an HR of 3.9 for DFS and 3.4 for CSS, while the tumor necrosis obtained an HR of 3.4 and 3, respectively.

            Conclusions: Presence of the micropapillary component and tumor necrosis were independent factors with poor prognosis in clinical outcome.