Lung adenocarcinoma with malignant serous effusions: A comprehensive clinicopathologic, molecular, and outcome analysis.
Pericardial malignant effusions had shortest overall survival among lung adenocarcinoma effusion sites
Lung adenocarcinoma with malignant serous effusions: A comprehensive clinicopathologic, molecular, and outcome analysis.
Malignant serous effusions (malignant serous effusions), including pleural, pericardial, and peritoneal effusions, are common in advanced lung adenocarcinoma (lung adenocarcinoma).
This study retrospectively analyzed 120 cytology-confirmed lung adenocarcinoma-associated malignant serous effusions cases from a single academic center by integrating gross fluid features, cytopathology, immunohistochemistry, targeted next-generation sequencing (next-generation sequencing), systemic therapy, and clinical outcomes, including survival from first malignant effusion (SME) and overall survival (OS).
Effusions were pleural (85 of 120; 70.8%), pericardial (28 of 120; 23.3%), and peritoneal (7 of 120; 5.8%).
Median SME was 3.8 months, and was shortest in the small peritoneal effusion subgroup (1.0 months).
TTF-1 positivity was associated with higher rates of actionable driver alterations and higher PD-L1 expression.
Dual TTF-1/PD-L1 negativity defined the poorest risk subgroup (median SME, 1.2 months; median OS, 1.4 months).
Integration of cytology, immunophenotype, genomics, and treatment delineates distinct prognostic subsets in lung adenocarcinoma with malignant serous effusions.
The absence of actionable driver alterations and TTF-1 negativity remains an independent adverse prognostic factor, with dual TTF-1/PD-L1-negative malignant serous effusions showing particularly poor SME and OS.