Margaritora, S. (Stefano)
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- Prognostic impact of lung adenocarcinoma second predominant pattern from a large European database(Willey, 2020) Aprile, V. (Vittorio); Lococo, F. (Filippo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Ampollini, L. (Luca); Nachira, D. (Dania); Viti, A. (Andrea); 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); Lucchi, M. (Marco); Paci, M. (Massimiliano); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido); Kestenholz, P. (Peter)Background and Objectives: Adenocarcinoma patterns could be grouped based on clinical behaviors: low‐ (lepidic), intermediate‐ (papillary or acinar), and high‐grade (micropapillary and solid). We analyzed the impact of the second predominant pattern (SPP) on disease‐free survival (DFS). Methods: We retrospectively collected data of surgically resected stage I and II adenocarcinoma. Selection criteria: anatomical resection with lymphadenectomy and pathological N0. Pure adenocarcinomas and mucinous subtypes were excluded. Recurrence rate and factors affecting DFS were analyzed according to the SPP focusing on intermediate‐grade predominant pattern adenocarcinomas. Results: Among 270 patients, 55% were male. The mean age was 68.3 years. SPP pattern appeared as follows: lepidic 43.0%, papillary 23.0%, solid 14.4%, acinar 11.9%, and micropapillary 7.8%. The recurrence rate was 21.5% and 5‐year DFS was 71.1%. No difference in DFS was found according to SPP (p = .522). In patients with high‐grade SPP, the percentage of SPP, age, and tumor size significantly influenced DFS (p = .016). In patients with lepidic SPP, size, male gender, and lymph‐node sampling (p = .005; p = .014; p = .038, respectively) significantly influenced DFS. Conclusions: The impact of SPP on DFS is not homogeneous in a subset of patients with the intermediate‐grade predominant patterns. The influence of high‐grade SPP on DFS is related to its proportion in the tumor.
- Pathological and clinical features of multiple cancers and lung adenocarcinoma: a multicentre study(2022) Aprile, V. (Vittorio); Lococo, F. (Filippo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Ampollini, L. (Luca); Nachira, D. (Dania); 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); Lucchi, M. (Marco); Paci, M. (Massimiliano); Lenzini, A. (Alessandra); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido); Kestenholz, P. (Peter)OBJECTIVES Lung cancer is increasingly diagnosed as a second cancer. Our goal was to analyse the characteristics and outcomes of early-stage resected lung adenocarcinomas in patients with previous cancers (PC) and correlations with adenocarcinoma subtypes. METHODS We retrospectively reviewed data of patients radically operated on for stage I–II lung adenocarcinoma in 9 thoracic surgery departments between 2014 and 2017. Overall survival (OS) and time to disease relapse were evaluated between subgroups. RESULTS We included 700 consecutive patients. PC were present in 260 (37.1%). Breast adenocarcinoma, lung cancer and prostate cancer were the most frequent (21.5%, 11.5% and 11.2%, respectively). No significant differences in OS were observed between the PC and non-PC groups (P = 0.378), with 31 and 75 deaths, respectively. Patients with PC had smaller tumours and were more likely to receive sublobar resection and to be operated on with a minimally invasive approach. Previous gastric cancer (P = 0.042) and synchronous PC (when diagnosed up to 6 months before lung adenocarcinoma; P = 0.044) were related, with a worse OS. Colon and breast adenocarcinomas and melanomas were significantly related to a lower incidence of high grade (solid or micropapillary, P = 0.0039, P = 0.005 and P = 0.028 respectively), whereas patients affected by a previous lymphoma had a higher incidence of a micropapillary pattern (P = 0.008). CONCLUSIONS In patients with PC, we found smaller tumours more frequently treated with minimally invasive techniques and sublobar resection, probably due to a more careful follow-up. The impact on survival is not uniform and predictable; however, breast and colon cancers and melanoma showed a lower incidence of solid or micropapillary patterns whereas patients with lymphomas had a higher incidence of a micropapillary pattern.
- 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.
- Prognostic role of standard uptake value according to pathologic features of lung adenocarcinoma(2021) Aprile, V. (Vittorio); Lococo, F. (Filippo); Carbognani, P. (Paolo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Nachira, D. (Dania); Viti, A. (Andrea); 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); Lucchi, M. (Marco); Paci, M. (Massimiliano); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido)Objective: To evaluate the influence of lung adenocarcinoma second predominant pattern on the maximal standard uptake value (SUVmax) and its prognostic effect in different histologic groups. Methods: We retrospectively collected surgically resected pathologic stage I and II lung adenocarcinoma from nine European institutions. Only patients who underwent preoperative PET-CT and with available information regarding SUVmax of T (SUVmaxT) and N1 (SUVmaxN1) component were included. Results: We enrolled 344 patients with lung adenocarcinoma. SUVmaxT did not show any significant relation according to the second predominant pattern (p = 0.139); this relationship remained nonsignificant in patients with similar predominant pattern. SUVmaxT influenced the disease-free survival in the whole cohort (p = 0.002) and in low- and intermediate-grade predominant pattern groups (p = 0.040 and p = 0.008, respectively). In the high-grade predominant pattern cohort and in the pathologic N1 cases, SUVmaxT lost its prognostic power. SUVmaxN1 did not show any significant correlation with predominant and second predominant patterns and did not have any prognostic impact on DFS. Conclusions: SUVmaxT is influenced only by the adenocarcinoma predominant pattern, but not by second predominant pattern. Concurrently, in high-grade predominant pattern and pN1 group the prognostic power of SUVmaxT becomes nonsignificant.