Risk Factors of Nodal Upstaging in Clinical Ia Lung Adenocarcinoma

Background and objective In clinical Ia (cT1N0M0) patients, some may have poor prognosis, for it might occur pathologic N1 (pN1) or N2 (pN2) postoperatively. The aim of this study is to determine the radiologicaland pathological factors related to clinical Ia adenocarcinoma. Methods The retrospective study was conducted on 297 clinical Ia adenocarcinoma patients resected at our hospital between May 2012 to December 2016. The clinical profiles, radiological and pathological features were analyzed between nodal upstaging group and non-upstaging group. Results Of 297 patients treated for cN0 tumors, 250 cases (84.2%) were confirmed postoperatively as having pN0 tumors, and 47 (15.8%) were confirmed as having pN1 or pN2 tumors. Female, low smoking index, micropapillary predominant and solid predominant adenocarcinoma, puresolid tumor and large tumor size were all more frequently seen in the nodal upstaging group than in the pN0 group (P<0.05). Logistic regression indicate that radiological solid tumor, micropapillary predominant and solid predominant adenocarcinoma and vessel invasionare the risk factors of nodal upstaging in clinical Ia adenocarcinoma. Conclusion Radiological solid tumors, micropapillary predominant and solid predominant adenocarcinoma andvessel invasion are risk factors for nodal upstaging for early stage lung cancer. Radiological solid tumors should perform SLND in Ia adenocarcinomas. ？