Long-Term Prognosis of Patients With Resected Adenocarcinoma In Situ and Minimally Invasive Adenocarcinoma of the Lung

Yotsukura, Masayuki; Asamura, Hisao; Motoi, Noriko; Kashima, Jumpei; Yoshida, Yukihiro; Nakagawa, Kazuo; Shiraishi, Kouya; Kohno, Takashi; Yatabe, Yasushi; Watanabe, Shun

doi:10.1016/j.jtho.2021.04.007

Cited by 93 publications

(65 citation statements)

References 35 publications

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“…In the revised 2021 classification of thoracic tumors, WHO includes AAH and AIS as precursor glandular lesions and classifies MIA and IAC as adenocarcinomas [ 6 ]. In the last decade, large-scale, systematic studies have shown that the long-term postoperative disease-specific survival of AIS and MIA may reach 100% [ 5 , 7 , 8 ]. The good long-term survival of patients with MIA indicates that surgical interventions may not benefit patients with AAH or AIS.…”

Section: Introductionmentioning

confidence: 99%

A CT-based nomogram for predicting the risk of adenocarcinomas in patients with subsolid nodule according to the 2021 WHO classification

Song

et al. 2022

Cancer Imaging

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Purpose To establish a nomogram for predicting the risk of adenocarcinomas in patients with subsolid nodules (SSNs) according to the 2021 WHO classification. Methods A total of 656 patients who underwent SSNs resection were retrospectively enrolled. Among them, 407 patients were assigned to the derivation cohort and 249 patients were assigned to the validation cohort. Univariate and multi-variate logistic regression algorithms were utilized to identity independent risk factors of adenocarcinomas. A nomogram based on the risk factors was generated to predict the risk of adenocarcinomas. The discrimination ability of the nomogram was evaluated using the concordance index (C-index), its performance was calibrated using a calibration curve, and its clinical significance was evaluated using decision curves and clinical impact curves. Results Lesion size, mean CT value, vascular change and lobulation were identified as independent risk factors for adenocarcinomas. The C-index of the nomogram was 0.867 (95% CI, 0.833-0.901) in derivation cohort and 0.877 (95% CI, 0.836-0.917) in validation cohort. The calibration curve showed good agreement between the predicted and actual risks. Analysis of the decision curves and clinical impact curves revealed that the nomogram had a high standardized net benefit. Conclusions A nomogram for predicting the risk of adenocarcinomas in patients with SSNs was established in light of the 2021 WHO classification. The developed model can be adopted as a pre-operation tool to improve the surgical management of patients.

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Section: Introductionmentioning

confidence: 99%

A CT-based nomogram for predicting the risk of adenocarcinomas in patients with subsolid nodule according to the 2021 WHO classification

Song

et al. 2022

Cancer Imaging

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“…Causes of GGN include inflammation, pulmonary fibrosis, and the most common early lung adenocarcinoma [ 9 ]. The study found that simple GGNs gradually evolved into lung adenocarcinoma (LA) during long-term follow-up, and lung adenocarcinoma was classified into atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC) [ 10 ]. Lung adenocarcinoma is more likely to metastasize earlier than lung squamous cell carcinoma, so lung adenocarcinoma has a poor prognosis and needs early diagnosis and treatment [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation Analysis of Computed Tomography Features and Pathological Types of Multifocal Ground-Glass Nodular Lung Adenocarcinoma

Kou

Kang

2022

Computational and Mathematical Methods in Medicine

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To investigate the correlation between computed tomography (CT) image characteristics of multiple lung ground-glass nodules (GGNs) and pathological classification, the CT image data of multiple lung GGN patients confirmed by pathology ( n = 132 ) in our hospital were collected. The imaging features of GGNs were analyzed by qualified physicians, including lesion size (diameter, volume, and mass), location, CT values (mean and relative CT values), lesion morphology (round and irregular), marginal structure (pagination and burr), internal structure (bronchial inflation sign), and adjacent structure (pleural depression). CT imaging analysis was performed for the subtype of infiltrating adenocarcinoma (IAC). In CT findings, GGNs were greatly different from adenomatous hyperplasia (AAH), pure GGN adenocarcinoma in situ (AIS), and microinvasive adenocarcinoma (MIA) in terms of marginal structure, lesion morphology, internal structure, adjacent structure, and size ( P < 0.05 ). The mean and relative CT values of mural adenocarcinoma, acinar adenocarcinoma, and papillary adenocarcinoma of IAC subtypes were greatly different from those of AAH/AIS/MIA ( P < 0.05 ). In summary, the CT images of GGNs can be used as the basis for the differentiation of AAH, AIS, and MIA early noninvasive types and IAC invasive types, and the CT value of the IAC subtype can be used as the basis for the classification and differentiation of IAC pathological subtypes.

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“…Different percentages of LC in part‐solid nodules may imply distinctive invasiveness and play an important role in patient outcomes. For example, the patients with adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA) had nearly 100% freedom from cancer‐specific death or recurrence 5,9,10 . In previous studies, 11–14 lepidic‐predominant invasive adenocarcinoma also carried more desirable prognosis than adenocarcinomas with other predominant subtypes, and led to more than 90% recurrence‐free survival (RFS).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of patients with different lepidic percentage and tumor size of stage I lung adenocarcinoma

et al. 2022

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Background To evaluate the long‐term outcomes after surgical resection for stage I lung adenocarcinoma based on the percentage of lepidic component (LC) and invasive tumor size (IS). Methods The clinicopathological characteristics of 1049 patients with stage I lung adenocarcinoma who underwent surgery between 2006 and 2016 were retrospectively reviewed. Tumors were categorized into groups: A (LC ≥ 50%) and B (LC < 50%). Groups A0 and A1 consisted of minimally invasive adenocarcinomas (MIA) and other lepidic‐predominant invasive adenocarcinomas, respectively. Group B was categorized into B1 (IS ≤ 1 cm), B2 (1 < IS≤2 cm), and B3 (2 < IS≤3 cm) by invasive tumor size and divided into subgroups (B1[lep+]/[lep−], B2[lep+]/[lep−], and B3[lep+]/[lep−]) according to the presence[lep+] or absence[lep−] of LCs. Cumulative incidence of recurrence (CIR) and cancer‐specific survival (CSS) were examined. Results LC decreased with increasing IS. Only 24 (8.5%) tumors in group A had an IS >1 cm. 10‐year CIR and CSS were 15.2% and 86.0%. LC and IS were found to be independent predictors of CSS. Patients in group A had 1.4% 10‐year CIR and 100% 10‐year CSS. In group B, a significantly higher CIR and worse CSS were observed as IS increased (p < 0.001), but LC was not a predictor for CSS (p = 0.593). No significant differences in CIR or CSS were found in presence of LC or not when LC < 50% (B1[lep+]/[lep−], B2[lep+]/[lep−], and B3[lep+]/[lep−]: p = 0.36/0.48, p = 0.82/0.94, and p = 0.90/0.37, respectively). Conclusions LC≥50% tumors demonstrated excellent prognosis regardless of IS. The outcomes of LC < 50% tumors were well predicted by IS, corresponding to the T‐staging system. The predictive value of LC for prognosis became insignificant.

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Long-Term Prognosis of Patients With Resected Adenocarcinoma In Situ and Minimally Invasive Adenocarcinoma of the Lung

Cited by 93 publications

References 35 publications

A CT-based nomogram for predicting the risk of adenocarcinomas in patients with subsolid nodule according to the 2021 WHO classification

A CT-based nomogram for predicting the risk of adenocarcinomas in patients with subsolid nodule according to the 2021 WHO classification

Correlation Analysis of Computed Tomography Features and Pathological Types of Multifocal Ground-Glass Nodular Lung Adenocarcinoma

Outcomes of patients with different lepidic percentage and tumor size of stage I lung adenocarcinoma

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