Solli, P. (Piergiorgio)

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    Impact of High-Grade Patterns in Early-Stage Lung Adenocarcinoma: A Multicentric Analysis
    (2022) Aprile, V. (Vittorio); Lococo, F. (Filippo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Nachira, D. (Dania); Solli, P. (Piergiorgio); Bacchin, D. (Diana); Imperatori, A. S. (Andrea Selenito); Margaritora, S. (Stefano); Terzi, A. C. (Alberto Claudio); Ruffini, E. (Enrico); Rodríguez-Pérez, M.C. (María C.); Bellafiore, S. (Salvatore); Minervini, F. (Fabrizio); Bogina, G. S. (Giuseppe Salvatore); Bocchialini, G. (Giovanni); Lucchi, M. (Marco); Paci, M. (Massimiliano); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido); Kestenholz, P. (Peter)
    Objective The presence of micropapillary and solid adenocarcinoma patterns leads to a worse survival and a significantly higher tendency to recur. This study aims to assess the impact of pT descriptor combined with the presence of high-grade components on long-term outcomes in early-stage lung adenocarcinomas. Methods We retrospectively collected data of consecutive resected pT1-T3N0 lung adenocarcinoma from nine European Thoracic Centers. All patients who underwent a radical resection with lymph-node dissection between 2014 and 2017 were included. Differences in Overall Survival (OS) and Disease-Free Survival (DFS) and possible prognostic factors associated with outcomes were evaluated also after performing a propensity score matching to compare tumors containing non-high-grade and high-grade patterns. Results Among 607 patients, the majority were male and received a lobectomy. At least one high-grade histological pattern was seen in 230 cases (37.9%), of which 169 solid and 75 micropapillary. T1a-b-c without high-grade pattern had a significant better prognosis compared to T1a-b-c with high-grade pattern (p = 0.020), but the latter had similar OS compared to T2a (p = 0.277). Concurrently, T1a-b-c without micropapillary or solid patterns had a significantly better DFS compared to those with high-grade patterns (p = 0.034), and it was similar to T2a (p = 0.839). Multivariable analysis confirms the role of T descriptor according to high-grade pattern both for OS (p = 0.024; HR 1.285 95% CI 1.033–1.599) and DFS (p = 0.003; HR 1.196, 95% CI 1.054–1.344, respectively). These results were confirmed after the propensity score matching analysis. Conclusions pT1 lung adenocarcinomas with a high-grade component have similar prognosis of pT2a tumors.