Controversy remains exist for the effect of adjuvant chemotherapy (ACT) among stage IB lung adenocarcinoma patients. This study aimed to investigate the predictive value of the current lung adenocarcinoma classification system on benefit of ACT among patients with stage IB lung adenocarcinoma.
A total of 928 pathological stage IB invasive adenocarcinoma patients with R0 resection were included in this study. Based on the predominant growth pattern present in the tumor, invasive adenocarcinomas with mixed histologic components were classified into five subtypes: lepidic (LEP), acinar (ACN), papillary (PAP), micropapillary (MIP) and solid (SOL). These five histologic subtypes were collapsed into three groups (LEP, ACN/PAP and SOL/MIP). Disease-free survival (DFS) and overall survival (OS) were analyzed to evaluate benefit from ACT in patients with different histologic patterns using the Kaplan–Meier approach and multivariable Cox models.
For all stage IB invasive adenocarcinoma patients, SOL/MIP subgroup presented the worst prognosis, and LEP subgroup showed approximately 100 % 5-year survival. ACT was associated with a better DFS (HR, 0.70; 95 % CI 0.51–0.96, p = .026) for all stage IB patients. In SOL/MIP subgroup, patients could benefit from ACT for a significant improved DFS (HR, 0.81; 95 % CI 0.49–1.35; p = .030), but not for OS (HR, 0.39; 95 % CI 0.12–1.30, p = .111). In ACN/PAP subgroup, there was no significant benefit from ACT for both DFS (HR, 0.76; 95 % CI 0.54–1.08, p = .125) and OS (HR, 0.81; 95 % CI 0.49–1.35, p = .421).
SOL/MIP predominant pattern was predictive for ACT benefit for DFS among invasive lung adenocarcinoma patients in stage IB.
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Dr Haiquan Chen is the guarantor of the manuscript. Dr Jizhuang Luo contributed to conception and study design, acquisition and analysis of data, and writing and revision of the manuscript. Dr Qingyuan Huang contributed to conception and study design, acquisition and analysis of data, and writing and revision of the manuscript. Dr Rui. Wang contributed to conception and study design, acquisition and analysis of data, and writing and revision of the manuscript. Dr Baohui Han contributed to conception and study design, acquisition and analysis of data, and revision of the manuscript. Dr Jie Zhang contributed to acquisition of data. Dr Heng Zhao contributed to acquisition of data and revision of the manuscript. Dr Wentao Fang contributed to analysis of data and revision of the manuscript. Dr Qingqian Luo contributed to analysis of data and revision of the manuscript. Dr Jun Yang contributed to acquisition of data and revision of the manuscript. Dr Yunhai Yang contributed to acquisition of data and revision of the manuscript. Dr Lei Zhu contributed to analysis of data. Dr Tianxiang Chen contributed to acquisition of data and revision of the manuscript. Dr Xinghua Cheng contributed to acquisition of data and revision of the manuscript. Dr Yiyang Wang contributed to acquisition of data and revision of the manuscript. Dr Jiajie Zheng contributed to analysis of data and revision of the manuscript. Dr Han Wu contributed to acquisition of data and revision of the manuscript. Dr Weicong Xia contributed to analysis of data and revision of the manuscript. Dr Haiquan Chen contributed to conception and study design, analysis of data and review and revision of the manuscript.
This work was funded by National Natural Science Foundation of China (81330056, 81401886, 81401891, 81422029 and 81372525) and Shen-kang Center Project (SKMB1201).
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Written informed consent was obtained from each patient to allow their biological samples to be genetically analyzed.
Jizhuang Luo, Qingyuan Huang and Rui Wang contributed equally to this work.
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Luo, J., Huang, Q., Wang, R. et al. Prognostic and predictive value of the novel classification of lung adenocarcinoma in patients with stage IB. J Cancer Res Clin Oncol 142, 2031–2040 (2016). https://doi.org/10.1007/s00432-016-2192-6
- Invasive lung adenocarcinoma
- Non-small-cell lung cancer
- Stage IB
- Adjuvant chemotherapy