Histological Scoring for Small Lung Adenocarcinomas 2 cm or Less in Diameter: A Reliable Prognostic Indicator

Abstract

The histologic scoring system comprising lymphovascular invasion-positive, non-BAC >10 mm and %solid/cribriform/papillary > or =30% is able to predict the outcome of lung adenocarcinomas 2 cm or less in diameter not only in all cases but also in overtly invasive adenocarcinomas. Minimally invasive adenocarcinomas did not recur in this large series.

Invasiveness and Malignant Potential of Pulmonary Lesions Presenting as Pure Ground-Glass Opacities

“…Minimally invasive adenocarcinoma (MIA) is defined as a small, solitary adenocarcinoma exhibiting a predominantly lepidic growth pattern and ≤5 mm invasion in the greatest dimension of any one plane. Several reports [9][10][11][12][13] have described patients with similarly defined lung MIA and a disease-specific survival rate of nearly 100%. Furthermore, some reports 14,15) have demonstrated that tumor malignancy depends on the maximum diameter or area of its solid component, excluding the ground-glass opacity (GGO) component.…”

Little Things Make Big Things Happen

“…17,18 In resected stage I NSCLC, ALI has occurred in 15% to 34% of cases 2,14,[19][20][21][22][23][24][25][26][27][28] and decreased both the 5-year DFS (86%-91% vs 50%-63%; HR, 0.2) and OS (90%-94% vs 66%-71%; HR, 1.8-3.2). 14,[19][20][21][22][23]25,28,29 Few published series have analyzed the impact of ALI on LA-NSCLC.…”

Clinicopathological characteristics of subcentimeter adenocarcinomas of the lung

“…These tumors were predominantly papillary, with high-grade nuclear atypia and lymphatic involvement. According to the recent IASLC/ATS/ERS classification proposal for lung adenocarcinoma [6,14], a solitary adenocarcinoma (≤3 cm) with a predominantly lepidic growth pattern and small foci of invasion measuring ≤5 mm is diagnosed as MIA and is associated with almost 100% disease-specific survival. In this study, of the 36 invasive carcinomas, 20 (56%) were MIA and 16 (44%) showed >5 mm invasion, 5 (14%) of which had no lepidic growth portions and were classified as entirely invasive carcinoma.…”