Respiratory Research & Clinical Practice
Pathological analysis of spread through air spaces in lung cancer patients: morphological characterization in a retrospective multicenter study
By Fernanda Wagner Fragomeni, Renata Fragomeni Almeida, Luiz Fernando Franzen Vinadé Neto and 2 others.
Abstract
Objective
To identify and characterize spread through air spaces (STAS), a recently recognized invasive growth pattern in lung adenocarcinoma that is associated with aggressive tumor behavior and poor oncologic outcomes. Its presence has important implications for surgical decision-making, particularly in early-stage disease.
Methods
This was a retrospective, multicenter observational study including 255 patients with lung adenocarcinoma who underwent surgical resection between January 2020 and December 2025 at one of two tertiary care hospitals in southern Brazil. Demographic, clinical, and pathological variables were analyzed, including age, sex, tumor size, histologic subtype, STAS, vascular embolization, pleural invasion, and type of surgery. Binomial logistic regression was performed to identify factors independently associated with STAS.