WCLC 2025 - Posters & ePosters-P1.07.30 Beyond the Lung: Distinct Recurrence Patterns of Mucinous and Non-Mucinous Lung Adenocarcinoma After Surgery

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This study from the Asan Medical Centre, Republic of Korea, investigates recurrence patterns of invasive mucinous adenocarcinoma (IMA) compared to invasive non-mucinous adenocarcinoma (INMA) of the lung after surgical treatment. IMA is a rare subtype representing 1–10% of lung adenocarcinomas with distinct clinical and pathological features from INMA. While previous studies suggested lower overall recurrence rates in IMA patients, detailed patterns of recurrence were not well elucidated.<br /><br />The authors conducted a matched analysis on patients without systemic or nodal metastases who underwent surgery, comparing the incidence of intrapulmonary (within the lungs) and extrapulmonary (outside the lungs) recurrences between IMA and INMA groups. Outcomes analyzed included freedom from recurrence (FFR) and cumulative incidence with competing-risks methodology.<br /><br />Key findings include:<br /><br />- IMA patients demonstrated significantly higher freedom from recurrence compared to INMA patients, both before and after propensity score matching.<br />- The overall recurrence rate was significantly lower in IMA cases.<br />- There was no significant difference in intrapulmonary recurrence rates between IMA and INMA.<br />- Importantly, IMA showed a markedly lower incidence of extrapulmonary recurrence compared to INMA.<br />- Multivariable competing risks analysis identified INMA histology and visceral pleural invasion (VPI) as independent poor prognostic factors for extrapulmonary recurrence.<br />- Other clinical factors like tumor size and lymphovascular invasion had less clear impact on recurrence types.<br /><br />The study concludes that the distinct recurrence pattern of IMA—characterized by a lower rate of extrapulmonary spread—likely accounts for its overall better post-surgical prognosis compared to INMA. These findings suggest that histological subtype influences metastatic behavior and recurrence risk in lung adenocarcinoma, with potential implications for surveillance and treatment strategies tailored to mucinous versus non-mucinous variants.

Asset Subtitle

Hyo Kyen Park

Meta Tag

Speaker Hyo Kyen Park

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

Invasive mucinous adenocarcinoma

Invasive non-mucinous adenocarcinoma

Lung adenocarcinoma

Recurrence patterns

Surgical treatment

Intrapulmonary recurrence

Extrapulmonary recurrence

Freedom from recurrence

Visceral pleural invasion

Propensity score matching