Correlation between spread through air spaces (STAS) and clinico-pathological parameters in lung cancer surgery

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Background: “Spread through airspace” (STAS) is defined as micropapillary clusters, solid nests or single cells of tumor extending beyond the edge of the tumor into the air spaces of the surrounding lung parenchyma.However, data on the correlation between the status of STAS and other lung cancer clinicopathological parameters are scarce. Methods: We reviewed resected lung cancers (lobectomies) and investigated the clinical significance of STAS in relation to other relevant lung cancer clinicopathological variables during two years (2023-2024) analised in the Department of Pathology, University of Medicine, Tirana. We performed univariate and multivariate logistic regression analyses with STAS as a dependent variable. Results: Of the total 57 patients, STAS was observed in 11patients (19 %) of them, with a median measure of the tumor 3.7 cm. Male to female ratio was approximately 4:1 (82% male:18% female) STAS is highly prevalent in adenocarcinoma (61.4%) than in other lung cancer growth patterns. STAS was significantly associated with advanced pN stage (p < 0.001) and lymphovascular invasion (p = 0.005). There is no correlation among gender or age and STAS. Histological grade was independently associated with the presence of STAS. Conclusion: Frequency of STAS was significantly higher with advanced pN stage and with lymphovascular invasion. Hence, it could serve as one of the prognostically significant histologic findings in lung cancer. Further prospective studies including data from multiple centers are needed to derive definitive conclusions.

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