The presence of spread through air spaces predicts poor postoperative survival in pathological IA stage non-small cell lung cancer patients: A meta-analysis

Abstract

Abstract Purpose Spread through air spaces (STAS) is an independent predictive indicator of poor survival in intermediate and advanced non-small cell lung cancer (NSCLC). However, whether the presence of STAS is significantly related to worse prognosis in early-stage NSCLC, especially in IA stage NSCLC, remains unclear. Thus, this study was designed to explore the role of STAS in predicting postoperative long-term survival of pathological IA stage NSCLC patients based on current evidence. Methods Several databases were searched up to January 16, 2023, for relevant studies. The primary and secondary outcomes were recurrence-free survival (RFS) and overall survival (OS)/cancer-specific survival (CSS). The hazard ratios (HRs) and 95% confidence intervals (CIs) were combined, and all statistical analyses were conducted by STATA 15.0 software. Results A total of eight retrospective studies were included. The pooled results demonstrated that the presence of STAS was significantly associated with worse RFS (HR = 1.84, 95% CI: 1.52–2.23, P < 0.001), OS (HR = 1.87, 95% CI: 1.47–2.39, P < 0.001) and CSS (HR = 2.03, 95% CI: 1.05–3.94, P = 0.035) in pathological IA stage NSCLC. In addition, subgroup analysis based on country showed similar results. Conclusion The presence of STAS is predictive of poor long-term survival of pathological IA stage NSCLC patients. However, more prospective high-quality studies are still needed to verify the above results.