Department of Respiratory Medicine, Shanxi Cancer Institute, Shanxi Cancer Hospital, Cancer Hospital of Chinese Academy of Medical Sciences Shanxi Hospital, Shanxi Medical University Affiliated Hospital, Taiyuan, 030000, China.
CAMS Key Laboratory of Translational Research on Lung Cancer，State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer /CancerHospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
BMC Cancer. 2024 Oct 25;24(1):1317. doi: 10.1186/s12885-024-13068-x.
Surgery is the optimal choice for early invasive mucinous lung adenocarcinoma (IMA). A systematic review and meta-analysis were conducted to explore the prognostic factors for resected IMA.
We systematically reviewed the prognostic role of clinicopathological and genomic factors in resected IMA patients. Eligible studies on the treatment of IMA following the systematic search of PubMed, Embase and the Cochrane Library from January 2015 to January 2024 were identified. Outcomes of interest were overall survival (OS) and disease-free survival/recurrence-free survival (DFS/RFS). The hazard ratio (HR) and 95% confidence interval (CI) were used as impact indicators for systematic review and meta-analysis.
Sixteen studies involving 3,484 patients with IMA were included. The results of the combined analysis showed that male and smoking were associated with a worse prognosis. Furthermore, advanced clinical stage, poor differentiation grade, presence of visceral pleural invasion (VPI) and spread through air spaces (STAS), and presence of KRAS mutations were also associated with worse prognosis.
Gender, smoking, clinical stage, tumor size, differentiation grading, VPI, STAS and KRAS mutation affect DFS/RFS and OS of IMA patients after surgery. Identifying these factors may aid physicians in developing more individualized treatment plans for resectable IMA patients.
手术是早期侵袭性黏液性腺癌（IMA）的最佳选择。本系统评价和荟萃分析旨在探讨可切除 IMA 患者的预后因素。
我们系统地回顾了临床病理和基因组因素在可切除 IMA 患者中的预后作用。从 2015 年 1 月至 2024 年 1 月，通过对 PubMed、Embase 和 Cochrane Library 的系统搜索，确定了关于 IMA 治疗的合格研究。感兴趣的结局是总生存（OS）和无病生存/无复发生存（DFS/RFS）。使用风险比（HR）和 95%置信区间（CI）作为系统评价和荟萃分析的影响指标。
纳入了 16 项涉及 3484 例 IMA 患者的研究。合并分析的结果表明，男性和吸烟与预后较差相关。此外，临床分期较晚、分化程度较差、存在内脏胸膜侵犯（VPI）和空气空间播散（STAS）以及存在 KRAS 突变也与预后较差相关。
性别、吸烟、临床分期、肿瘤大小、分化分级、VPI、STAS 和 KRAS 突变影响手术切除后 IMA 患者的 DFS/RFS 和 OS。识别这些因素可能有助于医生为可切除的 IMA 患者制定更个体化的治疗计划。
