WCLC 2025 - Posters & ePosters-P3.18.01 Sex-Based Differences in STAS Positivity and Survival in Stage I Lung Adenocarcinoma: Is Female Prognosis Still Better Despite STAS?

P3.18.01 Sex-Based Differences in STAS Positivity and Survival in Stage I Lung Adenocarcinoma: Is Female Prognosis Still Better Despite STAS?

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This retrospective study analyzed 296 patients with surgically resected Stage I lung adenocarcinoma (2016-2024) to evaluate sex-based differences in tumor spread through air spaces (STAS) positivity and survival outcomes. STAS, an adverse prognostic factor, was identified histopathologically in 111 cases. The cohort comprised 53.7% males (n=159) and 46.2% females (n=137).<br /><br />Key findings include a significantly higher STAS positivity in males (44.7%) compared to females (29.2%) (p=0.001). Smoking prevalence and more aggressive histologic subtypes (micropapillary/solid) were also higher among men, while women more frequently exhibited lepidic or non-mucinous patterns. Tumor size, T stage, resection type, and visceral pleura invasion did not differ significantly between sexes. Tumors ≤2 cm and STAS negativity were common in both genders (p=0.04).<br /><br />Importantly, female patients demonstrated better overall survival across multiple subgroups, including comparisons stratified by STAS status and histologic subtype (p≤0.001). Notably, women with STAS positivity had improved survival compared to STAS-positive men, although the survival difference between STAS-positive and STAS-negative women was not statistically significant. The best survival was observed in women with lepidic tumors, and worst in men with acinar-papillary histology.<br /><br />The study concludes that female sex confers a survival advantage in early-stage lung adenocarcinoma even in the presence of STAS. This suggests female sex may be a protective modifier against STAS-associated risk, likely influenced by immune-genetic and hormonal factors. These findings advocate for considering sex-specific factors in lung cancer prognosis, screening, and personalized treatment approaches.<br /><br />Keywords: lung adenocarcinoma, STAS, sex differences, survival, early-stage NSCLC, prognostic factors.

Asset Subtitle

süleyman günes

Meta Tag

Speaker süleyman günes

Topic Clinical Trials in Progress

Keywords

lung adenocarcinoma

STAS

sex differences

survival outcomes

early-stage NSCLC

prognostic factors

histologic subtypes

smoking prevalence

tumor spread through air spaces

female survival advantage