Journal of Diagnostics Concepts & Practice >

2026 , Vol. 25 >Issue 04: 399 - 405

DOI: https://doi.org/10.16150/j.1671-2870.2026.04.002

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Clinical significance and research progress of spread through air spaces （STAS） in non-small cell lung cancer

  • ZHONG Hua ,
  • HUANG Litang ,
  • DU Huawei
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  • Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China

Received date: 2026-05-07

  Revised date: 2026-07-16

  Accepted date: 2026-07-16

  Online published: 2026-08-31

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Abstract

Spread through air spaces (STAS), defined as the presence of tumor cells within the air spaces of the lung parenchyma beyond the edge of the main tumor, represents a novel pattern of invasion in lung cancer. Since its formal definition by the World Health Organization in 2015, STAS has fundamentally reshaped the risk stratification and treatment paradigms for non-small cell lung cancer (NSCLC). With the publication of data from the large-scale JCOG0802/WJOG4607L clinical trials conducted by the Japan Clinical Oncology Group and the West Japan Oncology Group, STAS has evolved from a mere pathological feature into an independent risk factor affecting recurrence-free survival (RFS) and overall survival (OS) in early-stage NSCLC, emerging as a pivotal biomarker for determining the surgical approach (lobectomy or sublobar resection) and postoperative adjuvant therapy decisions. This review systematically outlines the definition, diagnosis, and preoperative multimodal imaging prediction models of STAS. Furthermore, it elucidates the selection of surgical resection extent based on STAS status and presents the latest evidence-based data regarding adjuvant therapy, aiming to provide practical guidance for clinicians in standardizing diagnosis and treatment.

Key words： Non-small cell lung cancer; Spread through air spaces; Sublobar resection; Adjuvant chemotherapy

Cite this article

ZHONG Hua , HUANG Litang , DU Huawei . Clinical significance and research progress of spread through air spaces （STAS） in non-small cell lung cancer[J]. Journal of Diagnostics Concepts & Practice, 2026 , 25(04) : 399 -405 . DOI: 10.16150/j.1671-2870.2026.04.002

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