Prognostic value of spread through air spaces in operated lung squamous cell carcinoma patients: A meta-analysis

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BACKGROUND: The presence of spread through air spaces (STAS) predicts poor long-term survival of lung cancer patients. However, the association between STAS and prognosis of operated lung squamous cell carcinoma (LSCC) remains unclear at this time. The aim of this meta-analysis was to further identify the prognostic value of STAS in surgical LSCC patients. METHODS: Several electronic databases were searched up to April 12, 2025 for relevant studies. The primary and secondary outcomes were progression-free survival and overall survival/cancer-specific survival, respectively. 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 9 studies involving 2884 cases were included and reviewed. The pooled results demonstrated that the presence of STAS was significantly associated with poor progression-free survival (HR = 1.84, 95% CI: 1.57-2.16, P< .001). Besides, STAS predicted poorer overall survival (HR = 1.75, 95% CI: 1.23-2.51, P = .002) and cancer-specific survival (HR = 1.73, 95% CI: 1.33-2.26, P < .001) in surgical LSCC. CONCLUSION: Based on current evidence, STAS was identified as a novel and valuable prognostic risk factor for operated LSCC patients. However, more prospective high-quality studies are still needed to verify above findings.

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