Spread Through Air Spaces is Significantly Associated With Brain Metastases in Less Than 2 cm Lung Adenocarcinomas
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: This study analysed the correlation between spread through air spaces (STAS) and brain metastasis, as a distant recurrence site in patients with early-stage (less than 2 cm tumour size) lung adenocarcinomas. METHODS: Data of 207 patients with ≤2 cm adenocarcinomas were retrospectively analysed. Fifty-two patients (25.1%) had STAS (STAS-P group) and 155 patients (74.9%) had no STAS (STAS-N group). Study period was from January 1, 2010 till December 31, 2021. The end of follow-up was December 31, 2024. The incidence of the brain metastasis was collected from the national health system database. RESULTS: The mean age of the 2 groups was 69 years in the STAS-P and 65.9 years in the STAS-N group. Brain metastasis occurred in 19.2% (10/52) and 7.7% (12/155) (P = .019) in the STAS-P and STAS-N groups, respectively. The disease-free interval till brain metastases was 24 (10-77) and 26 (6-71) months (P = .832) in the STAS-P and STAS-N groups, respectively. In brain metastasis cases, the most frequent adenocarcinoma subtype was acinar (36.3%) and solid (27.3%). In a subgroup analysis of 117 patients, operated between 2015 and 2021, the median progression-free survival (PFS) was 59 (0-113) months in the STAS-P and 71 (1-119) months in the STAS-N group (P = .046). CONCLUSIONS: The presence of STAS in ≤2 cm adenocarcinomas is significantly associated with brain metastasis. In case of STAS, brain metastasis developed earlier, and PFS was significantly shorter. Brain metastases developed most typically after solid and acinar adenocarcinomas.
Institutions: University of Szeged, Kistarcsai Flór Ferenc Kórház
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,699
OpenAlex ID: W7127572212