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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Aged, Carcinoma, Squamous Cell, Female, Follow-Up Studies, Humans, Lung Neoplasms, Male, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Retrospective Studies.
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Is spread Through Air Spaces ( STAS ) an Independent Predictor of Recurrence and Lung Cancer Specific Death in Squamous Cell Carcinoma? Context: Spread through air spaces (STAS) is a recently recognized pattern of invasion in lung adenocarcinoma, however, it has not yet been characterized in squamous cell carcinoma (SCC). We reviewed 445 resected stage I-III lung SCC and investigated the clinical significance of STAS. Cumulative incidence of recurrence (CIR) and lung cancer-specific death (CID) were evaluated by competing risks analyses and overall survival (OS) by Cox models. Of total 445 patients, 336 (76%) were >65 years old. Among 273 patients who died, 91 (33%) died of lung cancer whereas the remaining died of competing events or unknown cause. STAS was observed in 132 patients (30%) and the frequency increased with stage. The cumulative incidence of any, distant, and locoregional recurrence as well as lung cancer-specific death were significantly higher in patients with STAS compared to those without STAS, whereas there was no statistically significant difference in OS. In multivariable models for any recurrence and lung cancer-specific death, STAS was an independent predictor for both outcomes (p=0.034 and 0.016, respectively).
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STAS was present in one third of resected lung SCC. In competing risks analysis in a cohort where three fourths of the patients were elderly, STAS was associated with lung cancer-specific outcomes. Our findings suggest that STAS is one of the most prognostically significant histologic findings in lung SCC. Final Decision: yes