In multivariate analysis both the cribriform component HR
In multivariate analysis, both the cribriform component (HR of RFS, 2.82, 95% CI, 1.68–4.74, p < 0.001; HR of OS, 2.73, 95% CI, 1.74–4.29, p < 0.001) and STAS (HR of RFS, 5.19, 95% CI, 3.10–8.69, p < 0.001; HR of OS, 4.27, 95% CI, 2.78–6.54, p < 0.001) were independent risk factors of inferior RFS and OS. Although some researchers once considered that ABT-888 (Veliparib) the poor prognostic association with STAS is due to other clinicopathological factors, our study found that STAS remained an independent prognostic predictor for worse outcomes, which was consistent with others [, , ,22,25]. Further logistic regression analyses identified that the cribriform component (OR, 2.21, 95% CI, 1.02–4.77, p = 0.044) was an independent risk factor for increased frequency of STAS. In view of this, we considered that the occurrence of STAS probably affected survival in adenocarcinoma patients with a cribriform component.
Among patients with a cribriform component, the survival analyses indicated that Crib+/STAS + patients had significantly inferior outcomes when compared with Crib+ /STAS- patients (RFS: 5-year rate, 4% vs. 32%, p < 0.001; OS: 5-year rate, 2% vs. 21%, p < 0.001), demonstrating the additional prognostic value provided by STAS for patients with a cribriform component. A multivariate Cox regression analysis further confirmed that STAS was an independent risk factor of inferior RFS (HR, 3.17, 95% CI, 1.61–6.26, p = 0.001) and OS (HR, 3.64, 95% CI, 1.90–6.96, p < 0.001) in patients with a cribriform component. Taken together, we consider that the existence of a cribriform component and a STAS-positive status should be regarded as synergistic prognostic factors in LUAD. Therefore, STAS may be one of the potential mechanisms by which the cribriform component leads to poor survival in postoperative patients.
Funding This work was supported by Jiangsu Provincial Commission of Health and Family Planning (grant numbers H201521); the Natural Science Foundation of Jiangsu Province (grant numbers BK20161224); Suzhou Key Discipline for Medicine (grant numbers SZXK201803); the Science and Technology Research Foundation of Suzhou Municipality (grant numbers SYS2018063, SYS2018064); National foundation of science and technology (grant numbers 81802989) and Hospital internal research foundation for PhD (grant numbers SDFEYBS1709).
Introduction Non-small cell lung cancer (NSCLC) staging determines both treatment and prognosis. Anatomic resection (with lymphadenectomy) is indicated in patients with early-stage NSCLC (