WCLC 2025 - Posters & ePosters-P1.07.07 The Presence of STAS Leads to Poor Prognosis After Sublobar Resection in Stage I NSCLC: Results From an Individual Patient Data Metanalysis

P1.07.07 The Presence of STAS Leads to Poor Prognosis After Sublobar Resection in Stage I NSCLC: Results From an Individual Patient Data Metanalysis

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This individual patient data meta-analysis evaluated the prognostic impact of tumor spread through air spaces (STAS) on surgical outcomes in stage I non-small cell lung cancer (NSCLC), comparing sublobar resection and lobectomy. STAS, recently recognized as an independent adverse factor in lung cancer, remains a challenge for determining the optimal surgical approach in early-stage NSCLC.<br /><br />The study included data from six reports involving 3,063 patients, 48% of whom underwent lobectomy, and 27.2% had tumors with STAS. Adenocarcinoma was the predominant histology (93.7%), and 52% of patients had a smoking history. Using reconstructed individual patient data from Kaplan-Meier curves, the analysis focused on overall survival (OS) and recurrence-free survival (RFS).<br /><br />Results showed that among patients with STAS-positive tumors, those treated with sublobar resection had significantly worse outcomes compared to lobectomy. Specifically, sublobar resections in the STAS group were associated with shorter RFS (hazard ratio [HR] 1.6, 95% CI 1.2–2.1; p=0.001) and shorter OS (HR 2.1, 95% CI 1.5–2.9; p=0.001). Conversely, in patients without STAS, sublobar resection was linked to improved RFS (HR 0.47, 95% CI 0.35–0.67; p=0.001) and OS (HR 0.4, 95% CI 0.29–0.57; p=0.001) compared to lobectomy.<br /><br />These findings indicate that the presence of STAS negatively impacts survival and recurrence when sublobar resection is performed in stage I NSCLC, suggesting lobectomy as the preferred surgical approach in STAS-positive tumors. The study underscores the need for further research to develop predictive methods for STAS to better guide surgical decision-making and optimize patient outcomes.

Asset Subtitle

Filippo Tommaso Gallina

Meta Tag

Speaker Filippo Tommaso Gallina

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

tumor spread through air spaces

STAS

stage I non-small cell lung cancer

NSCLC

sublobar resection

lobectomy

prognostic impact

overall survival

recurrence-free survival

adenocarcinoma