Prognostic value of ROS1 rearrangement in lung adenocarcinoma stratified by clinicopathologic and radiological features: a retrospective cohort study
Abstract
Background The prognostic significance of ROS1 rearrangement in lung adenocarcinoma (LUAD) remains a subject of debate. This study systematically evaluated the clinicopathologic characteristics and prognostic impact of ROS1 rearrangement in early- and advanced-stage LUAD, stratified by distinct clinicopathologic and radiological features. Methods We retrospectively analyzed comprehensive clinical data and follow-up records of patients with resected invasive LUAD who underwent ROS1 testing between 2018 and 2020. Patients were stratified by tumor stage (I vs. II–III), radiographic pattern (part-solid vs. solid), histologic differentiation (moderate vs. poor), and pathologic aggressiveness (passive vs. aggressive, defined by the presence of lymphovascular invasion, visceral pleural invasion, or spread through air spaces). The prognostic significance of ROS1 rearrangement was assessed within each subgroup. Results Among 3,162 enrolled patients, 145 (4.5%) were ROS1 rearrangement-positive. ROS1 rearrangement was associated with non-smoking status, pure solid nodules, poor differentiation, and lymphovascular invasion. ROS1 rearrangement was associated with significantly worse recurrence-free survival (RFS) and overall survival (OS) in patients with stage II–III disease, solid radiographic pattern, poor differentiation, and aggressive pathologic features. In contrast, RFS and OS were comparable between ROS1-positive and -negative patients in the stage I, part-solid, moderately…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 3,162 participants or records.
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