Comparison of clinical results between high grade patterns in stage I lung adenocarcinoma

Abstract

Background: The histological subtype has been introduced in invasive lung adenocarcinoma. The predominant micropapillary and solid subtypes are categorized as high-grade patterns and provide a worse prognosis. However, the prognostic analysis of high-grade patterns has not previously been fully investigated. Thus, this study aimed to investigate the prognostic role of high-grade patterns in pathological stage I lung adenocarcinoma. Methods: Patients with stage I lung adenocarcinoma and micropapillary or solid components were reviewed. Clinicopathological features and clinical course were compared in these subtypes, and prognostic factors were analyzed in high-grade patterns. Results: The patients were classified into five groups based on the presence of micropapillary or solid subtypes, namely, micropapillary predominant, solid predominant, both nonpredominant subtypes, only minor micropapillary subtype, and only minor solid subtype present. Disease-free interval was significantly different, and the micropapillary predominant group showed worse disease-free interval (p = 0.001). Contrastingly, the solid predominant group showed significantly worse overall survival among high-grade patterns (p = 0.035). The multivariate analysis revealed an association between smoking, micropapillary predominant, blood vessel invasion, and visceral pleural invasion with recurrence and more association between solid predominant and visceral pleural invasion with overall survival. Conclusions: Clinical results were different in stage I high-grade adenocarcinoma. The predominant micropapillary subtype is the independent prognostic factor for recurrence. However, the solid subtype is the significant factor for overall survival. Furthermore, the predominant subtype is the most valuable and independent prognostic factor for predicting recurrence or survival.

Predictive scoring of high‐grade histology among early‐stage lung cancer patients: The MOSS score

“…It allows prognostic stratification in terms of overall survival (OS) and recurrence‐free survival (RFS) in all cancer stages, as well as in the subgroup of stage I patients. Additionally, IASLC grade 3 has been identified as the most relevant risk factor for predicting clinical outcomes 9,10 …”

“…Additionally, IASLC grade 3 has been identified as the most relevant risk factor for predicting clinical outcomes. 9,10 As intraoperative biopsy results are often inconclusive, more extensive pulmonary resection or lymph node dissection may be required to avoid the need for additional surgery. Several studies have reported preoperative clinical and radiological variables that are predictive factors for micropapillary, solid pattern, and IASLC grade 3 cancer.…”

Lung adenocarcinoma with micropapillary and solid patterns: Recurrence rate and trends

“…9,10 Recently, it has been reported that patients with MP have a high postoperative recurrence rate and poor overall survival (OS). [2][3][4][5] As for the type of recurrence, lymph node metastasis was more likely in lung adenocarcinoma patients with MP. 6,7 Nitadori et al also reported that local recurrence was more common in patients with MP after partial resection and that MP might spread within the lung tissue.…”

“…Lung adenocarcinoma is the major histological type of lung cancer and is further classified into five subtypes: lepidic, acinar, papillary, solid, and micropapillary. Solid and micropapillary patterns are subtypes considered to have a poor prognosis and have been reported to have a high postoperative recurrence rate 1–8 . However, the current TNM classification does not reflect these factors, and treatment according to histological subtype has not yet been established.…”

Identification of upstream immunoregulators that target protein co-expression networks significantly associated with early-stage micropapillary/solid predominant lung adenocarcinomas

“…Recently, Jeon et al compared the clinicopathological features and clinical course of patients with the MPA and SPA subtypes, including predominant and non-predominant subtypes after curative resection of stage I lung adenocarcinoma and analyzed the prognostic factors. The clinical results were different for stage I high-grade adenocarcinoma and the predominant micropapillary subtype was an independent prognostic factor for recurrence, whereas the solid subtype was a signi cant factor for overall survival [7].…”