European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026
Primary pulmonary enteric adenocarcinoma: A single-institute retrospective study on its imaging classification and survival outcomes.
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Du He, Li Wei, Wang Jingyi, Wu Shixing, Song Nan, Wan Ziwei, Shi Jingyun, Wu Fengying
Аннотация
BACKGROUND: As an extremely rare independent pathological subtype of lung adenocarcinoma, PEAC exhibits potentially distinct clinicopathological, radiological, and molecular characteristics. Currently, there were no large-sample studies reporting its features.
METHODS: Patients with PEAC who underwent surgical resection from March 2013 to December 2023 were included in the study. The clinicopathological, imaging features, radiological subtypes and recurrence patterns were analyzed. Recurrence-free survival (RFS) and overall survival (OS) were assessed by Kaplan-Meier curves and compared between groups using log-rank tests. Cox proportional hazards models were used to assess associations with outcomes.
RESULTS: The final study population consisted of 81 patients (mean age, 63 years; age range, 36-79 years) including 60 men and 21 women. Radiologically, lesion subtypes were categorized as part-solid (6.2 %, 5/81), pure-solid (90.1 %, 73/81), and pneumonic-type PEAC (3.7 %, 3/81). Pneumonic-type PEACs were more prevalent in higher clinical T stages, whereas all part-solid PEACs were confined to the T1 stage (P = .001). In the part-solid subtype group, both RFS and OS rate were significantly higher than those in the pneumonic-type group and the pure-solid group (P = .001 and P = .0095). Tumor-node-metastasis(TNM) stage III emerged as an independent risk factor for recurrence (hazard ratio, 4.699 [95 % confidence interval: 1.967, 11.080]; P < .001). Pathological nodal involvement (hazard ratio, 24.301 [95 % confidence interval: 5.172, 114.195]; P < .001) was as independent predictor of poor OS. Intrapulmonary metastasis was identified as the predominant recurrence pattern in PEAC.
CONCLUSION: PEAC had distinct imaging characteristics. Survival outcomes vary significantly across different imaging subtypes, with prognosis largely determined by TNM stage.
METHODS: Patients with PEAC who underwent surgical resection from March 2013 to December 2023 were included in the study. The clinicopathological, imaging features, radiological subtypes and recurrence patterns were analyzed. Recurrence-free survival (RFS) and overall survival (OS) were assessed by Kaplan-Meier curves and compared between groups using log-rank tests. Cox proportional hazards models were used to assess associations with outcomes.
RESULTS: The final study population consisted of 81 patients (mean age, 63 years; age range, 36-79 years) including 60 men and 21 women. Radiologically, lesion subtypes were categorized as part-solid (6.2 %, 5/81), pure-solid (90.1 %, 73/81), and pneumonic-type PEAC (3.7 %, 3/81). Pneumonic-type PEACs were more prevalent in higher clinical T stages, whereas all part-solid PEACs were confined to the T1 stage (P = .001). In the part-solid subtype group, both RFS and OS rate were significantly higher than those in the pneumonic-type group and the pure-solid group (P = .001 and P = .0095). Tumor-node-metastasis(TNM) stage III emerged as an independent risk factor for recurrence (hazard ratio, 4.699 [95 % confidence interval: 1.967, 11.080]; P < .001). Pathological nodal involvement (hazard ratio, 24.301 [95 % confidence interval: 5.172, 114.195]; P < .001) was as independent predictor of poor OS. Intrapulmonary metastasis was identified as the predominant recurrence pattern in PEAC.
CONCLUSION: PEAC had distinct imaging characteristics. Survival outcomes vary significantly across different imaging subtypes, with prognosis largely determined by TNM stage.