Mitosis Trumps T Stage and Proposed International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification for Prognostic Value in Resected Stage 1 Lung Adenocarcinoma

Duhig, Edwina; Dettrick, Andrew; Godbolt, David; Pauli, J.; Zwieten, Anthony van; Hansen, Aaron R.; Yang, Ian A.; Fong, Kwun M.; Clarke, Belinda; Bowman, Rayleen V.

doi:10.1097/jto.0000000000000446

Cited by 33 publications

(18 citation statements)

References 27 publications

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“…31,32 However, it would be useful to stratify further the intermediate-grade acinar and papillary adenocarcinomas, and this may be a good role for nuclear grading and mitotic counts. [27][28][29]33,34 However, more investigation is needed to address which approach is clinically relevant. For resected squamous cell carcinomas, there is very little data available, but nuclear diameter has been shown to be an independent predictor of worse outcome.…”

Section: Histologic Grading Of Lung Cancermentioning

confidence: 99%

The 2015 World Health Organization Classification of Lung Tumors

Travis

Brambilla

Nicholson

et al. 2015

Journal of Thoracic Oncology

3,473

1,196

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The 2015 World Health Organization (WHO) Classification of Tumors of the Lung, Pleura, Thymus and Heart has just been published with numerous important changes from the 2004 WHO classification. The most significant changes in this edition involve (1) use of immunohistochemistry throughout the classification, (2) a new emphasis on genetic studies, in particular, integration of molecular testing to help personalize treatment strategies for advanced lung cancer patients, (3) a new classification for small biopsies and cytology similar to that proposed in the 2011 Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification, (4) a completely different approach to lung adenocarcinoma as proposed by the 2011 Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification, (5) restricting the diagnosis of large cell carcinoma only to resected tumors that lack any clear morphologic or immunohistochemical differentiation with reclassification of the remaining former large cell carcinoma subtypes into different categories, (6) reclassifying squamous cell carcinomas into keratinizing, nonkeratinizing, and basaloid subtypes with the nonkeratinizing tumors requiring immunohistochemistry proof of squamous differentiation, (7) grouping of neuroendocrine tumors together in one category, (8) adding NUT carcinoma, (9) changing the term sclerosing hemangioma to sclerosing pneumocytoma, (10) changing the name hamartoma to "pulmonary hamartoma," (11) creating a group of PEComatous tumors that include (a) lymphangioleiomyomatosis, (b) PEComa, benign (with clear cell tumor as a variant) and

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Section: Histologic Grading Of Lung Cancermentioning

confidence: 99%

The 2015 World Health Organization Classification of Lung Tumors

Travis

Brambilla

Nicholson

et al. 2015

Journal of Thoracic Oncology

3,473

1,196

View full text Add to dashboard Cite

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“…DUHIG et al [28] examined 145 stage I adenocarcinomas and found that lepidic adenocarcinoma had 100% survival, with survival for acinar/papillary and solid adenocarcinomas of 70% and 55%, respectively. These authors concluded that mitotic count was the best stratifier, even within solid, acinar and papillary subtypes.…”

Section: Stage 1 Adenocarcinomamentioning

confidence: 99%

Prognostic considerations of the new World Health Organization classification of lung adenocarcinoma

Borczuk

2016

Eur Respir Rev

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The 2015 World Health Organization (WHO) lung adenocarcinoma classification divides tumours into categories of indolent pre-invasive, minimally invasive and predominantly lepidic and, by examining predominant patterns of invasion, allows for further stratification into intermediate and highgrade tumours. The impact of the 2015 classification on prognosis was reviewed by a PubMed search for search terms "adenocarcinoma", "lung pathology" and "prognosis" and relevant publications reviewed. These were sorted for data on stage and survival as impacted by histological classification, and survival studies were separated into all stage versus stage 1 studies. Predictive aspects of histological classification were also examined, but molecular correlates were not. The separation of adenocarcinoma in situ and minimally invasive adenocarcinoma from invasive subtypes as distinct prognostic entities and the prognostic significance, for disease specific and overall survival for low-and high-grade categories, are discussed. The impact on stage at presentation including risk of node metastasis by histology is examined, as well as histology in relation to recurrence after surgery. Early data with regard to the value of predominant histology in the prediction of chemotherapy response will also be explored. @ERSpublications Lepidic lung ADC often early stage and indolent; solid and micropapillary tumours often metastatic and recurrent http://ow.ly/DCiT305xExK

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“…Also, Kadota et al demonstrated a significant association of mitotic count with histology grade, Ki‐67 proliferative index, and recurrence‐free probability, and concluded that mitotic count was the single most important predictor of recurrence in patients with stage 1 lung adenocarcinoma . In another study, Duhig et al suggested that mitotic index is the only independent prognostic marker for patients who have undergone resection for stage I lung adenocarcinoma …”

Section: Discussionmentioning

confidence: 99%

Mitosis count and number of cancer cells in cases of primary pulmonary adenocarcinoma: Correlations among phosphorylated histone 3, number of cancer cells, nuclear grade, pathologic features and prognosis

Inoue

Nakazato

Karube

et al. 2018

Pathology International

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Immunohistochemistry findings for the phosphorylated form of histone 3 (pHH3) have been shown to be a reliable mitosis-specific marker. We evaluated the correlation between pHH3-stained mitotic figures (PHMFs) and clinical outcome, and compared the results with findings for numbers of PHMFs and cancer cells. The primary tumor was obtained from 113 patients with pulmonary adenocarcinomas (≤2 cm maximum dimension). All specimens were stained with pHH3, then the number of cancer cells in each was determined. Cases with a cancer-cell index ≥1000 showed worse recurrence-free survival as compared to those with a value <1000 (P < 0.001). Also, cases with a pHH3 index ≥0.27 showed worse recurrence-free survival as compared to <0.27 (P = 0.001) and cases with a pHH3/cancer-cell index ≥0.001 showed worse recurrence-free survival as compared to <0.001 (P = 0.002). Multivariate analysis demonstrated that pHH3/cancer-cell index was significantly correlated with prognosis, but not Ki-67 index. The number of cancer cells was also strongly correlated with progression of Noguchi's classification and WHO pathologic type. pHH3/cancer-cell index was correlated with prognosis, and those were useful for prognostic evaluation of pulmonary adenocarcinoma patients. Furthermore, cancer cell number was correlated with Noguchi's classification and WHO pathologic type.

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Mitosis Trumps T Stage and Proposed International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification for Prognostic Value in Resected Stage 1 Lung Adenocarcinoma

Cited by 33 publications

References 27 publications

The 2015 World Health Organization Classification of Lung Tumors

The 2015 World Health Organization Classification of Lung Tumors

Prognostic considerations of the new World Health Organization classification of lung adenocarcinoma

Mitosis count and number of cancer cells in cases of primary pulmonary adenocarcinoma: Correlations among phosphorylated histone 3, number of cancer cells, nuclear grade, pathologic features and prognosis

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