This study investigates the impact of tumor spread through air spaces (STAS) on surgical outcomes for early-stage non-small cell lung cancer (NSCLC). In a retrospective analysis of 785 patients, 19.2 percent were found to have STAS-positive NSCLC. The study revealed no significant difference in overall survival (OS) or recurrence-free survival (RFS) between segmentectomy and lobectomy for STAS-negative patients. However, for STAS-positive patients, segmentectomy was associated with significantly worse outcomes, with a three-year OS of 58.4 percent compared to 89.0 percent for lobectomy (p < 0.001), and a three-year RFS of 69.8 percent vs. 82.7 percent (p < 0.001). This study is crucial for the cardiothoracic surgery community as it reinforces the need for careful surgical planning in STAS-positive NSCLC cases. It highlights the importance of considering STAS status when choosing between segmentectomy and lobectomy to optimize oncological outcomes.
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Tumour Spread Through Air Spaces Is a Determiner for Treatment of Clinical Stage I Non-Small Cell Lung Cancer: Thoracoscopic Segmentectomy vs Lobectomy
Submitted by: Akshay Patel
Source: Lung Cancer
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Author(s): Lin Huang, René Horsleben Petersen
1 Comment
A sublobar resection in patients with STAS has already been shown to be associated with worse oncologic outcomes. Also, it is not possible to identify STAS preoperatively so your statement that we must consider it during surgical planning is misleading.