TY  - JOUR
T1  - Spread through air spaces as a prognostic factor in resected non-small cell lung cancer
TT  - Rezeke edı̇len küçük hücrelı̇ dışı akcı̇ğer kanserı̇nde prognostı̇k bı̇r faktör olarak hava boşluklarına yayılım
AU  - Keskin, Gül Sema
AU  - Yıldırım, Gizem
AU  - Aslan, Volkan
AU  - Kadan, Elcin
AU  - Sapmaz, Ersin
AU  - Aykan, Musa Barış
AU  - Ertürk, İsmail
AU  - Karadurmuş, Nuri
PY  - 2025
DA  - September
Y2  - 2025
DO  - 10.38053/acmj.1738996
JF  - Anatolian Current Medical Journal
JO  - Anatolian Curr Med J / ACMJ / acmj
PB  - MediHealth Academy Yayıncılık
WT  - DergiPark
SN  - 2718-0115
SP  - 569
EP  - 575
VL  - 7
IS  - 5
LA  - en
AB  - Aims: To evaluate the prognostic impact of spread through air spaces (STAS) in patients with resected non-small cell lung cancer (NSCLC) and to investigate its association with clinicopathological features and survival outcomes.Methods: A retrospective analysis was conducted on 207 patients with pathological stage IA–IIIA NSCLC who underwent curative-intent surgery between 2018 and 2024. STAS was defined as the presence of micropapillary clusters, solid nests, or single tumor cells within alveolar spaces beyond the main tumor. Patients were categorized as STAS-positive or STAS-negative. Disease free survival (DFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Univariate and multivariate Cox regression models were used to assess prognostic factors.  Results: STAS was identified in 57% of patients. STAS positivity was significantly associated with poor differentiation, a higher rate of lymphovascular invasion, and increased use of adjuvant chemotherapy. Median DFS was 29.9 months in STAS-positive patients but was not reached in STAS-negative patients (p
KW  - Non-small cell lung cancer
KW  - STAS
KW  - disease-free survival
KW  - prognostic factors
KW  - surgery
N2  - Amaç: Bu çalışmanın amacı, rezeke edilmiş küçük hücreli dışı akciğer kanseri (KHDAK) hastalarında hava boşlukları yoluyla yayılımın (STAS) prognostik etkisini değerlendirmek ve STAS’ın klinikopatolojik özellikler ile sağkalım sonuçlarıyla ilişkisini araştırmaktır.Yöntemler: 2018–2024 yılları arasında küratif amaçlı cerrahi uygulanan patolojik evre IA–IIIA KHDAK tanılı 207 hastanın verileri retrospektif olarak analiz edildi. STAS, ana tümör sınırları dışında alveoler boşluklarda mikropapiller kümeler, solid adacıklar veya tekil tümör hücrelerinin varlığı olarak tanımlandı. Hastalar STAS-pozitif ve STAS-negatif olarak sınıflandırıldı. Hastalıksız sağkalım (DFS) ve genel sağkalım (OS), Kaplan–Meier yöntemi ile hesaplandı. Prognostik faktörler, univaryant ve multivaryant Cox regresyon analizleri ile değerlendirildi.Bulgular: Hastaların %57’sinde STAS pozitifliği saptandı. STAS pozitifliği; kötü diferansiasyon, artmış lenfovasküler invazyon ve adjuvan kemoterapi kullanım oranı ile anlamlı şekilde ilişkiliydi. STAS pozitif hastalarda medyan DFS 29.9 ay iken, STAS negatif hastalarda medyan DFS’ye ulaşılamadı (p  < 0.001). Multivaryant analizde STAS, hastalıksız sağkalım için bağımsız bir kötü prognostik faktör olarak belirlendi (HR: 2.38; %95 GA: 1.34–4.23; p = 0.003). STAS ile genel sağkalım arasında istatistiksel olarak anlamlı bir ilişki saptanmadı (p = 0.079).Sonuç: STAS, rezeke edilmiş KHDAK hastalarında hastalıksız sağkalımı olumsuz yönde etkileyen bağımsız bir prognostik faktördür. Erken evre hastalar başta olmak üzere, STAS varlığı prognostik değerlendirme ve cerrahi planlamada dikkate alınmalıdır.
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UR  - https://doi.org/10.38053/acmj.1738996
L1  - https://dergipark.org.tr/tr/download/article-file/5040579
ER  -