Lepidic component identifies a subgroup of lung adenocarcinoma with a distinctive prognosis: a multicenter propensity-matched analysis

Erjia Zhu; Chenyang Dai; Huikang Xie; Hang Su; Xuefei Hu; Ming Li; Junqiang Fan; Jinshi Liu; Quan Zhu; Lei Zhang; Honggang Ke; Chang Chen

doi:10.1177/1758835920982845

Lepidic component identifies a subgroup of lung adenocarcinoma with a distinctive prognosis: a multicenter propensity-matched analysis

Ther Adv Med Oncol. 2020 Dec 23:12:1758835920982845. doi: 10.1177/1758835920982845. eCollection 2020.

Authors

Erjia Zhu¹, Chenyang Dai¹, Huikang Xie², Hang Su¹, Xuefei Hu¹, Ming Li³, Junqiang Fan⁴, Jinshi Liu⁵, Quan Zhu⁶, Lei Zhang⁷, Honggang Ke⁸, Chang Chen⁹

Affiliations

¹ Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
² Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
³ Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing, People's Republic of China.
⁴ Department of Thoracic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
⁵ Department of Thoracic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.
⁶ Department of Thoracic Surgery, Jiangsu Province Hospital, Nanjing, People's Republic of China.
⁷ Department of Thoracic Surgery, The First People's Hospital of Changzhou, Changzhou, People's Republic of China.
⁸ Department of Thoracic Surgery, Affiliated Hospital of Nantong University, Nantong University, Nantong, People's Republic of China.
⁹ Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Zhengmin Road 507, Shanghai 200443, China.

Abstract

Background: Our aim was to investigate the prognostic impact of the lepidic component on T stage in patients with lung adenocarcinoma (LUAD).

Methods: A retrospective data set including 863 cases of LUAD with lepidic component and 856 cases without lepidic component was used to identify matched lepidic-positive and lepidic-negative cohorts (n = 376 patients per group) using a propensity-score matching. Primary outcome variables included recurrence-free survival (RFS) and overall survival (OS). Prognostic factors were assessed by Cox regression analysis and Kaplan-Meier estimates.

Results: Multivariate analysis revealed that lepidic component presence was an independent prognostic factor for prolonged RFS (p < 0.001) and OS (p < 0.001). Furthermore, lepidic ratio (LR) >25% or ⩽25% were confirmed to be independent prolonged survival predictors. No survival differences were observed between patients with LUAD with LR >25% or ⩽25% (RFS p = 0.333; OS p = 0.078). The 5-year OS rates of patients with LUAD with a lepidic component were 90% regardless of the T stage, and these survival rates were significantly better than those of patients with LUAD without a lepidic component in the corresponding T stage. Multivariate analysis confirmed that T stage was associated with survival only in patients with LUAD without a lepidic component.

Conclusions: Lepidic component presence identifies a LUAD subgroup with an excellent prognosis independent of the LR, pathological T classification. Considering the lepidic component presence may improve prognostic predictions for patients with LUAD.

Keywords: T classification; ground-glass opacity; lepidic component; lung adenocarcinoma.