WCLC 2025 - Posters & ePosters-EP.01.20 Non-Smoking Lung Adenocarcinoma: Implications for Predominant Growth Patterns, Tumor Heterogeneity and Prognosis

EP.01.20 Non-Smoking Lung Adenocarcinoma: Implications for Predominant Growth Patterns, Tumor Heterogeneity and Prognosis

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This study investigated differences in lung adenocarcinoma growth patterns, tumor heterogeneity, and prognosis between smokers and non-smokers, analyzing 507 patients with stage I pulmonary adenocarcinoma who underwent surgery. Non-smokers were significantly more often female (75.5% vs. 45.7%) and exhibited a higher frequency of low-grade tumors (19.4% vs. 10.0%) and lower frequency of high-grade tumors (26.5% vs. 42.1%), based on IASLC tumor grading. Predominantly, non-smokers showed lepidic growth patterns (19.4% vs. 10.5%) and were less likely to have solid predominant growth patterns (6.1% vs. 14.4%), with tumor samples reflecting higher proportions of lepidic and lower proportions of solid growth patterns compared to smokers.<br /><br />The solid growth pattern, more common in smokers, was previously linked to poorer prognosis, including early and multisite recurrence. This study confirmed that solid tumor components negatively impact recurrence-free survival (RFS). Median follow-up was 67 months; non-smokers trended toward better 5-year RFS (78.5% vs. 71.8%) though not statistically significant. Multivariable Cox regression identified smoking as an independent risk factor for worse RFS (HR 1.836; p=0.012), alongside other clinical factors.<br /><br />The findings underscore distinct biological and histological differences in lung adenocarcinoma related to smoking status, with non-smoking tumors showing less aggressive growth patterns and better prognosis. The study also supports previous Japanese cohort data indicating higher-grade solid patterns are associated with smoking but extends the evidence to a European population. These results highlight the importance of considering smoking status and tumor growth patterns to refine prognostic assessment and potentially tailor treatment strategies in lung adenocarcinoma patients.

Asset Subtitle

Erik Rolf

Meta Tag

Speaker Erik Rolf

Topic Risk Factors, Risk Reduction & Tobacco Control

Keywords

lung adenocarcinoma

smoking status

tumor growth patterns

tumor heterogeneity

prognosis

lepidic growth pattern

solid growth pattern

recurrence-free survival

IASLC tumor grading

stage I pulmonary adenocarcinoma