Spread Through Air Spaces (STAS) in Surgically Resected Lung Adenocarcinoma Prognosis

To investigate the association between tumor spread through air spaces (STAS) and prognosis in surgically resected lung adenocarcinoma in our hospital, the clinicopathological data of 201 patients accepting lung adenocarcinoma surgery from January 2019 to December 2019 were retrospectively reviewed in our hospital. The correlation between clinicopathological features especially the status of STAS and patients’ overall survival and disease-free survival was explored. In addition, subgroup analysis was used to explore the association between STAS and prognosis. A total of 41 (20.4%) patients had positive STAS in hematoxylin and eosin (HE) staining sections. The median follow-up time was 41.03 months, and 16 patients died at the end of the follow-up. On multivariate analysis, Ki67 (HR, 1.019; 95% CI, 1.001–1.037) and STAS (HR, 2.396; 95% CI, 1.054–5.446) were found to be associated with disease-free survival (DFS). However, only pleural invasion (HR, 3.845; 95% CI, 1.196–12.363) was considered to be the independent factor for prognosis in our group. In the STAS-positive group, overall survival (OS) and DFS were significantly lower in patients undergoing sublobar resection than in the lobectomy group. In stage I-II patients, OS and DFS were significantly lower in the STAS-positive group than in the STAS-negative group. In conclusion, STAS is an independent risk factor of poor DFS in resected lung adenocarcinoma patients.