Analysis of prognostic factors after Surgery for Stage IA Invasive Lung Adenocarcinoma

Abstract Background Lung cancer is one of the most common malignant tumors with poor prognosis. Even for stage IA, many cases relapsed after completed resection. In the era of precision medicine, it is of great significance to determine the risk factors for postoperative recurrence or death in stage IA invasive lung adenocarcinoma. Methods The data of patients with pathological stage IA invasive lung adenocarcinoma underwent complete resection from June 2012 to December 2016 in Fujian Provincial Hospital were collected and retrospectively analyzed. Recurrence-free survival (RFS) was estimated by the Kaplan-Meier method and compared with the log-rank test. The Cox proportional risk model was used to analyze the factors affecting the RFS. Results A total of 210 patients were enrolled in the study. During the follow-up period, 14 (6.7%) patients recurred. Univariate survival analysis showed that predominant pathological subtype, micropapillary/solid pattern, stage T1b and lymphovascular invasion were correlated with RFS (P < 0.05). Cox multivariate analysis showed that the micropapillary/solid pattern was associated with RFS (P < 0.01). Patients with micropapillary/solid pattern had a worse 5-year RFS rate than those without micropapillary/solid pattern (82.3% versus 96.7%, P < 0.001). Conclusion Pathological subtype is a prognostic factor for patients with pathological stage IA invasive lung adenocarcinoma. Patients with micropapillary/solid pattern have a poor prognosis. Lymphovascular invasion and stage T1b are also correlated with poor RFS. These findings may serve as reliable predictive factors for long-term prognostic, and provide theory evidence for the choice of postoperative adjuvant therapy for patients with lung adenocarcinoma in stage IA.