Division of Thoracic Surgery, Erlangen University Hospital, Erlangen, Germany.
Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Thorac Cardiovasc Surg. 2023 Mar;71(2):138-144. doi: 10.1055/s-0042-1757632. Epub 2022 Oct 18.
Spread through air spaces (STAS) is a recently described route of tumor invasion associated with poor prognosis in primary lung cancer. Aim of this study was to investigate the presence of STAS and to assess its prognostic significance in patients undergoing pulmonary metastasectomy (PM) for solitary metastases from colorectal cancer (CRC).
All 49 CRC patients (30 male and 19 female, median age 66 years) who underwent PM between January 2008 and December 2015 were retrospectively analyzed.
STAS was identified in 26.5% ( = 13) of resected specimens. Location of pulmonary lesions (central vs. peripheral) was assessed based on the available computed tomography imaging ( = 47, 96%). STAS was detected in all five patients with central metastases (100%) versus 7 of 42 (17%) with peripheral metastases ( = 0.0001). Locoregional recurrence occurred in STAS-positive patients ( = 4 of 13 vs. = 0 of 36), all STAS-negative patients remained recurrence-free ( = 0.003). Median number of alveoli with STAS involvement was four (range from 2 to 9). There was statistically positive relationship between the number of alveoli invaded with STAS and locoregional recurrence of metastases ( = 0.0001). The presence of STAS is not a factor affecting the 5-year overall survival rate ( = 0.6651).
We identified STAS as a frequent finding in resected CRC lung metastases and found insignificant association with outcome.
空气空间扩散（STAS）是一种最近描述的肿瘤侵袭途径，与原发性肺癌的不良预后相关。本研究旨在调查 STAS 的存在，并评估其在接受肺转移瘤切除术（PM）的结直肠癌（CRC）单一转移患者中的预后意义。
回顾性分析了 2008 年 1 月至 2015 年 12 月期间接受 PM 的 49 例 CRC 患者（30 名男性和 19 名女性，中位年龄 66 岁）。
在切除标本中发现 STAS 占 26.5%（ = 13）。根据可获得的 CT 影像学评估肺部病变的位置（中央与外周）（ = 47，96%）。在 5 例中央转移患者中均检测到 STAS（100%），而在 42 例外周转移患者中仅 7 例（17%）检测到 STAS（ = 0.0001）。STAS 阳性患者出现局部区域复发（ = 4 例比 36 例中的 0 例），所有 STAS 阴性患者均未出现复发（ = 0.003）。STAS 受累的肺泡数量中位数为 4 个（范围为 2 至 9）。STAS 侵犯的肺泡数量与转移瘤局部区域复发之间存在统计学上的正相关（ = 0.0001）。STAS 的存在不是影响 5 年总生存率的因素（ = 0.6651）。
我们发现 STAS 是结直肠癌肺转移切除标本中的常见发现，但与预后无显著关联。
