title: Prognosis and status of lymph node involvement in patients with adenocarcinoma in situ and minimally invasive adenocarcinoma-a systematic literature review and pooled-data analysis.
abstract: BACKGROUND
  Adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) have been brought up that substitute for bronchioloalveolar carcinoma (BAC), according to the new classification of lung adenocarcinoma. There has been increasing opinions that argues for the adjustment of lymph node disposition in patients with such early stage tumors. Therefore, we sought to overview the prognosis and status of lymph node involvement in AIS/MIA patients.
  
  
  METHODS
  PubMed, Springer and Ovid databases were searched for relevant studies. Data was extracted and results summarized to demonstrate the disposition of lymph nodes in AIS/MIA.
  
  
  RESULTS
  Twenty-three studies consisting of 6,137 lung adenocarcinoma were included. AIS/MIA accounted for 821 of the total 6,137. All included patients received curative surgery. After a review of the summarized data we found that only one patient (with MIA) had N1 node metastasis, N2 disease was not found in any of the included patients. In concordance with this, studies that reported 5-year disease free survival (5-year DFS) have almost 100% rate.
  
  
  CONCLUSIONS
  Our findings indicated that patients with AIS/MIA have good survival prognosis after surgical resection, and that recurrence and lymph node metastasis in these patients is rare. Therefore, we strongly encouraged further studies to determine the role of different lymph node disposition strategies.
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Long
authors.initials: L
authors.lastname: Jiang
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Yin
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Guilin
authors.initials: G
authors.lastname: Peng
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Zhang
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Shengyi
authors.initials: S
authors.lastname: Zhong
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Qihua
authors.initials: Q
authors.lastname: He
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liang
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Thoracic Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Jianxing
authors.initials: J
authors.lastname: He
keywords: Adenocarcinoma in situ (AIS); lymph node involvement; minimally invasive adenocarcinoma (MIA)