Loose Tumor Cells in Pulmonary Arteries of Lung Adenocarcinoma Resection Specimens: No Correlation With Survival, Despite High Prevalence. in Archives of pathology & laboratory medicine / Arch Pathol Lab Med. 2024 May 1;148(5):588-594. doi: 10.5858/arpa.2023-0009-OA.
2024
ASL Cuneo 2
Tipo pubblicazione
Validation Study
Autori/Collaboratori (12)Vedi tutti...
Dickhoff C
the Department of Surgery and Cardiothoracic Surgery, Amsterdam UMC-Cancer Center Amsterdam, the Netherlands (Dickhoff).
Smit AAJ
the Department of Pulmonology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (Smit).
Schonau A
PathoPulse, Soborg, Denmark (Schonau).
et alii...
Abstract
CONTEXT: Loose tumor cells and tumor cell clusters can be recognized in the lumen of intratumoral pulmonary arteries of resected non-small cell lung cancer specimens. It is unclear whether these should be considered tumor-emboli, and as such could predict a worsened prognosis. OBJECTIVE: To investigate the nature and prognostic impact of pulmonary artery intraluminal tumor cells. DESIGN: This multicenter study involved an exploratory pilot study and a validation study from 3 institutions. For the exploratory pilot study, a retrospective pulmonary resection cohort of primary adenocarcinomas, diagnosed between November 2007 and November 2010, were scored for the presence of tumor cells, as well as potentially other cells in the intravascular spaces, using hematoxylin-eosin and cytokeratin 7 (CK7) stains. In the validation part, 2 retrospective cohorts of resected pulmonary adenocarcinomas, between January 2011 and December 2016, were included. Recurrence-free survival (RFS) and overall survival (OS) data were collected. RESULTS: In the pilot study, CK7+ intravascular cells, mainly tumor cells, were present in 23 of 33 patients (69.7%). The 5-year OS for patients with intravascular tumor cells was 61%, compared with 40% for patients without intravascular tumor cells (P = .19). In the validation study, CK7+ intravascular tumor cells were present in 41 of 70 patients (58.6%). The 5-year RFS for patients with intravascular tumor cells was 80.0%, compared with 80.6% in patients without intravascular tumor cells (P = .52). The 5-year OS rates were, respectively, 82.8% and 71.6% (P = .16). CONCLUSIONS: Loose tumor cells in pulmonary arterial lumina were found in most non-small cell lung cancer resection specimens and were not associated with a worse RFS or OS. Therefore, most probably they represent an artifact.
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PMID : 37638545
DOI : 10.5858/arpa.2023-0009-OA
Keywords
Humans; Lung Neoplasms/surgery/pathology/mortality; Pulmonary Artery/pathology/surgery; Male; Female; Aged; Middle Aged; Retrospective Studies; Pilot Projects; Adenocarcinoma of Lung/surgery/pathology/mortality; Prognosis; Prevalence; Neoplastic Cells, Circulating/pathology; Adenocarcinoma/pathology/surgery/mortality; Aged, 80 and over; Keratin-7/metabolism/analysis;