Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin JHM, Beasley MB, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol. 2015;10:1243–60.

PubMed  Google Scholar 

Shiono S, Yanagawa N. Spread through air spaces is a predictive factor of recurrence and a prognostic factor in stage I lung adenocarcinoma. Interact Cardiovasc Thorac Surg. 2016;23:567–72.

PubMed  Google Scholar 

Kadota K, Nitadori JI, Sima CS, Ujiie H, Rizk NP, Jones DR, et al. Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stage I lung adenocarcinomas. J Thorac Oncol. 2015;10:806–14.

CAS  PubMed  PubMed Central  Google Scholar 

Dai C, Xie H, Su H, She Y, Zhu E, Fan Z, et al. Tumor spread through air spaces affects the recurrence and overall survival in patients with lung adenocarcinoma >2 to 3 cm. J Thorac Oncol. 2017;12:1052–60.

PubMed  Google Scholar 

Toyokawa G, Yamada Y, Tagawa T, Kozuma Y, Matsubara T, Haratake N, et al. Significance of spread through air spaces in resected pathological stage I lung adenocarcinoma. Ann Thorac Surg. 2018;105:1655–63.

PubMed  Google Scholar 

Eguchi T, Kameda K, Lu S, Bott MJ, Tan KS, Montecalvo J, et al. Lobectomy is associated with better outcomes than sublobar resection in spread through air spaces (STAS)-positive T1 lung adenocarcinoma: a propensity score-matched analysis. J Thorac Oncol. 2019;14:87–98.

PubMed  Google Scholar 

Saji H, Okada M, Tsuboi M, Nakajima R, Suzuki K, Aokage K, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022;399:1607–17.

CAS  PubMed  Google Scholar 

Tane S, Okami J, Maniwa Y, Shintani Y, Ito H, Ohtsuka T, et al. Clinical outcomes of left upper segmentectomy vs. lobectomy for early non-small-cell lung cancer: a nationwide database study in Japan. Surg Today. 2024;54:1162–72.

PubMed  PubMed Central  Google Scholar 

Li H, Li L, Liu Y, Deng Y, Zhu Y, Huang L, et al. Predictive value of CT and (18)F-FDG PET/CT features on spread through air space in lung adenocarcinoma. BMC Cancer. 2024;24:434.

PubMed  PubMed Central  Google Scholar 

Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11:39–51.

PubMed  Google Scholar 

Lee MA, Kang J, Lee HY, Kim W, Shon I, Hwang NY, et al. Spread through air spaces (STAS) in invasive mucinous adenocarcinoma of the lung: incidence, prognostic impact, and prediction based on clinicoradiologic factors. Thorac Cancer. 2020;11:3145–54.

CAS  PubMed  PubMed Central  Google Scholar 

Uruga H, Fujii T, Fujimori S, Kohno T, Kishi K. Semiquantitative assessment of tumor spread through air spaces (STAS) in early-stage lung adenocarcinomas. J Thorac Oncol. 2017;12:1046–51.

PubMed  Google Scholar 

Shiono S, Endo M, Suzuki K, Yarimizu K, Hayasaka K, Yanagawa N. Spread through air spaces is a prognostic factor in sublobar resection of non-small cell lung cancer. Ann Thorac Surg. 2018;106:354–60.

PubMed  Google Scholar 

Yang L, Yang Y, Ma P, Zheng B, Liu W, Zhang Z, et al. Spread through air spaces predicts a worse survival in patients with stage I adenocarcinomas >2 cm after radical lobectomy. J Thorac Dis. 2018;10:5308–17.

PubMed  PubMed Central  Google Scholar 

Kagimoto A, Tsutani Y, Kushitani K, Kai Y, Kambara T, Miyata Y, et al. Segmentectomy vs lobectomy for clinical stage IA lung adenocarcinoma with spread through air spaces. Ann Thorac Surg. 2021;112:935–43.

PubMed  Google Scholar 

Shimomura M, Miyagawa-Hayashino A, Omatsu I, Asai Y, Ishihara S, Okada S, et al. Spread through air spaces is a powerful prognostic predictor in patients with completely resected pathological stage I lung adenocarcinoma. Lung Cancer. 2022;174:165–71.

PubMed  Google Scholar 

Lv Y, Li S, Liu Z, Ren Z, Zhao J, Tao G, et al. Impact of surgery and adjuvant chemotherapy on the survival of stage I lung adenocarcinoma patients with tumor spread through air spaces. Lung Cancer. 2023;177:51–8.

CAS  PubMed  Google Scholar 

Shiono S, Endo M, Suzuki K, Yanagawa N. Spread through air spaces affects survival and recurrence of patients with clinical stage IA non-small cell lung cancer after wedge resection. J Thorac Dis. 2020;12:2247–60.

PubMed  PubMed Central  Google Scholar 

Zhang Z, Liu Z, Feng H, Xiao F, Shao W, Liang C, et al. Predictive value of radiological features on spread through air space in stage cIA lung adenocarcinoma. J Thorac Dis. 2020;12:6494–504.

PubMed  PubMed Central  Google Scholar 

Yamamoto M, Tamura M, Miyazaki R, Okada H, Wada N, Toi M, et al. Mean computed tomography value to predict spread through air spaces in clinical N0 lung adenocarcinoma. J Cardiothorac Surg. 2024;19:260.

PubMed  PubMed Central  Google Scholar 

Imamura Y, Azuma K, Kurata S, Hattori S, Sasada T, Kinoshita T, et al. Prognostic value of SUVmax measurements obtained by FDG-PET in patients with non-small cell lung cancer receiving chemotherapy. Lung Cancer. 2011;71:49–54.

PubMed  Google Scholar 

Nakamura H, Saji H, Shinmyo T, Tagaya R, Kurimoto N, Koizumi H, et al. Close association of IASLC/ATS/ERS lung adenocarcinoma subtypes with glucose-uptake in positron emission tomography. Lung Cancer. 2015;87:28–33.

PubMed  Google Scholar 

Kawabata K, Takahashi T, Nishida T, Kurokawa Y, Yamamoto K, Saito T, et al. 18F-fluorodeoxyglucose positron emission tomography-computed tomography as a prognostic marker of imatinib-resistant gastrointestinal stromal tumors. Surgery Today. 2025;55: Epub ahead of print.

Nishimori M, Iwasa H, Miyatake K, Nitta N, Nakaji K, Matsumoto T, et al. 18F FDG-PET/CT analysis of spread through air spaces (STAS) in clinical stage I lung adenocarcinoma. Ann Nucl Med. 2022;36:897–903.

CAS  PubMed  Google Scholar 

Wang Y, Lyu D, Cheng C, Zhou T, Tu W, Xiao Y, et al. Preoperative nomogram for predicting spread through air spaces in clinical-stage IA non-small cell lung cancer using (18)F-fluorodeoxyglucose positron emission tomography/computed tomography. J Cancer Res Clin Oncol. 2024;150:185.

CAS  PubMed  PubMed Central  Google Scholar 

Benchimol S, Fuks A, Jothy S, Beauchemin N, Shirota K, Stanners CP. Carcinoembryonic antigen, a human tumor marker, functions as an intercellular adhesion molecule. Cell. 1989;57:327–34.

CAS  PubMed  Google Scholar 

Zhang Z, Zhao Y, Ma YJ, Chen CQ, Li ZY, Wang YK, et al. Prediction of STAS in lung adenocarcinoma with nodules </= 2 cm using machine learning: a multicenter retrospective study. BMC Cancer. 2025;25:417.

CAS  PubMed  PubMed Central  Google Scholar 

Eguchi T, Matsuoka S, Iwaya M, Kobayashi S, Seshimoto M, Mishima S, et al. Improving intraoperative diagnosis of spread through air spaces: a cryo-embedding-medium inflation method for frozen section analysis. JTCVS Tech. 2024;25:170–6.

PubMed  PubMed Central  Google Scholar