Polish Journal of Pathology
eISSN: 2084-9869
ISSN: 1233-9687
Polish Journal of Pathology
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Ethical standards and procedures Supplements Instructions for authors Publication charge
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Share:
Share:
Original paper

Prognostic impact of spread through air spaces and its association with KRAS mutation and histopathologic factors in resected colorectal lung metastases

Gonca Gül Geçmen
1
,
Sevinç Hallaç Keser
1
,
Dilek Ece
2
,
Şermin Çoban Kökten
1
,
Berk Çimenoğlu
3
,
Ayşen Güler
1
,
Arif Pala
1
,
Sibel Sensu
1

  1. Department of Pathology Clinic, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
  2. Department of Pathology Clinic, Istanbul Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
  3. Department of Thoracic Surgery Clinic, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
prognostic factors, pathology, KRAS, pulmonary metastasectomy, colorectal cancer, spread through air spaces (STAS).
Online publish date: 2026/05/06
Article file
- Prognostic impact.pdf  [5.03 MB]
Get citation
 
PlumX metrics:
 
1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61: 69-90.
2. Parnaby CN, Bailey W, Balasingam A, Beckert L, Eglinton T, Fife J, et al. Pulmonary staging in colorectal cancer: a review. Colorectal Dis 2012; 14: 660-670.
3. Mitry E, Guiu B, Cosconea S, Jooste V, Faivre J, Bouvier AM. Epidemiology, management and prognosis of colorectal cancer with lung metastases: a 30-year population-based study. Gut 2010; 59: 1383-1388.
4. Iida T, Nomori H, Shiba M, Nakajima J, Okumura S, Horio H, et al. Metastatic Lung Tumor Study Group of Japan. Prognostic factors after pulmonary metastasectomy for colorectal cancer and rationale for determining surgical indications: a retro- spective analysis. Ann Surg 2013; 257: 1059-1064.
5. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA,  Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394-424.
6. 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: 806-814.
7. Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. Introduction to The 2015 World Health Organization Classification of Tumors of the Lung, Pleura, Thymus, and Heart. J Thorac Oncol 2015; 10: 1240-1242.
8. Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin JHM, Beasley MB, et al. WHO Panel. 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: 1243-1260.
9. Meng M, Zhong K, Jiang T, Liu Z, Kwan HY, Su T. The current understanding on the impact of KRAS on colorectal cancer. Biomed Pharmacother 2021; 140: 111717.
10. László L, Kurilla A, Takács T, Kudlik G, Koprivanacz K, Buday L, et al. Recent updates on the significance of KRAS mutations in colorectal cancer biology. Cells 2021; 10: 667.
11. Ye J, Lin M, Zhang C, Zhu X, Li S, Liu H, et al. Tissue gene mutation profiles in patients with colorectal cancer and their clinical implications. Biomed Rep 2020; 13: 43-48.
12. Kang D, Li J, Li Y, Xu J, Yang J, Zhang Z. Prognostic significance of KRAS, NRAS, BRAF, and PIK3CA mutations in stage II/III colorectal cancer: a retrospective study and meta-analysis. PLoS One 2025; 20: e0320783.
13. Pfannschmidt J, Muley T, Hoffmann H, Dienemann H. Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experiences in 167 patients. J Thorac Cardiovasc Surg 2003; 126: 732-739.
14. Cho S, Song IH, Yang HC, Jheon S. Prognostic factors of pulmonary metastasis from colorectal carcinoma. Interact Cardiovasc Thorac Surg 2013; 17: 303-307.
15. Watanabe K, Nagai K, Kobayashi A, Sugito M, Saito N. Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer. Br J Surg 2009; 96: 1058-1065.
16. Tsitsias T, Toufektzian L, Routledge T, Pilling J. Are there recognized prognostic factors for patients undergoing pulmonary metastasectomy for colorectal carcinoma? Interact Cardiovasc Thorac Surg 2016; 23: 962-969.
17. Shalabi A, Shalabi SF, Graeter T, Welter S, Ehab A, Kuon J. Low rates of intrapulmonary local recurrence after laser metastasectomy: a single-center retrospective cohort study of colorectal cancer metastases. Cancers (Basel) 2025; 17: 683.
18. Welter S, Jacobs J, Krbek T, Poettgen C, Stamatis G. Prognostic impact of lymph node involvement in pulmonary metastases from colorectal cancer. Eur. J. Cardio Thorac Surg 2007; 31: 167-172.
19. Shiono S, Ishii G, Nagai K, Yoshida J, Nishimura M, Murata Y, et al. Histopathologic prognostic factors in resected colorectal lung metastases. Ann Thorac Surg 2005; 79: 278-282.
20. Shirakusa T, Tsutsui M, Motonaga R, Ando K, Kusano T. Resection of metastatic lung tumor: the evaluation of histologic appearance in the lung. Am Surg 1988; 54: 655-658.
21. Karjula T, Kemi N, Niskakangas A, Mustonen O, Puro I, Pohjanen VM, et al. The prognostic role of tumor budding and tumor-stroma ratio in pulmonary metastasis of colorectal carcinoma. Eur J Surg Oncol 2023; 49: 1298-1306.
22. Hirohashi S. Inactivation of the E-cadherin-mediated cell adhesion system in human cancers. Am J Pathol 1998; 153: 333-339.
23. Shiono S, Ishii G, Nagai K, Murata Y, Tsuta K, Nitadori J, et al. Immunohistochemical prognostic factors in resected colorectal lung metastases using tissue microarray analysis. Eur J Surg Oncol 2006; 32: 308-309.
24. Zhang Y, Wu Z, Zhang B, Hu H, Zhang J, Chen Y, et al. Prognostic impact of high-risk factors and KRAS mutation in patients with stage II deficient mismatch repair colon cancer: a retrospective cohort study. Ann Transl Med 2022; 10: 702.
25. Takeda-Miyata N, Konishi E, Tanaka T, Shimomura M, Tsunezuka H, Okada S, et al. Prognostic significance of spread through air spaces in pulmonary metastases from colorectal cancer. Lung Cancer 2020; 149: 61-67.
26. Haj Khalaf MA, Sirbu H, Hartmann A, Agaimy A, Dudek W, Higaze M, et al. Spread through air spaces (STAS) in solitary pulmonary metastases from colorectal cancer (CRC). Thorac Cardiovasc Surg 2023; 71: 138-144.
27. Castro PM, Rei J, Silva C, Miranda J, Guerra M. Spreading through air spaces and thinking about lung metastases. Port J Card Thorac Vasc Surg 2023; 30: 31-35.
Copyright: © 2026 Polish Association of Pathologists and the Polish Branch of the International Academy of Pathology This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Quick links
© 2026 Termedia Sp. z o.o.
Developed by Termedia.