Prognostic impact according to the proportion of the lepidic subtype in stage <scp>IA</scp> acinar‐predominant lung adenocarcinoma

Jeon, Hyun Woo; Kim, Young-Du; Sim, Sung Bo; Moon, Myung Sang

doi:10.1111/1759-7714.14013

Cited by 11 publications

(11 citation statements)

References 16 publications

(25 reference statements)

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“…Invasive lung adenocarcinoma has mixed subtypes, and a favorable prognosis may be associated with the lepidic subtype proportion. 16,17 Solid or MP predominant subtypes are known as highgrade malignancies in invasive lung adenocarcinoma. 18 Many studies have been found on solid or MP predominant subtypes, which are associated with poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Discussionmentioning

confidence: 99%

“…Lepidic predominant invasive lung adenocarcinoma has also been reported to have favorable outcomes as a low‐grade malignancy. Invasive lung adenocarcinoma has mixed subtypes, and a favorable prognosis may be associated with the lepidic subtype proportion 16,17 …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…In our study, the analysis of these factors found different predominant subtypes did have different long-term OS and DSF effects. Specifically, the low-grade group had a better prognosis ( 2 ), and the high-grade group, which includes solid and micropapillary tumors, was frequently associated with a poor prognosis ( 16 , 24 - 27 ). This is consistent with results from previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Lung cancer is a common malignant tumor with a high mortality rate ( 1 ), and lung adenocarcinoma (LUAD) is currently the most common histological subtype of non-small cell lung cancer ( 2 ). A new classification method of lung cancer was provided by the American Thoracic Society (ATS), the European Respiratory Society (ERS), and the International Association for the Study of Lung Cancer (IASLC) in 2011 ( 3 ) and was published by the World Health Organization (WHO) in 2015 ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Prognosis of the second predominant subtype in lung adenocarcinoma: a retrospective single-center cohort study

Sun¹,

Li²,

Li³

et al. 2022

J Thorac Dis

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Background: The histologic classification of lung adenocarcinoma (LUAD) was mainly divided into three pathological subtype groups: the low-grade predominant subtype group (lepidic), the intermediategrade predominant subtype group (papillary and acinar), and the high-grade predominant subtype group (micropapillary and solid). Previous studies have focused on the prognostic impact of predominant subtypes of lung adenocarcinoma. In this investigation, we investigated the effect of the second predominant subtype on prognosis. Methods:The data of LUAD postoperative patients were retrospectively collected. Exclusion criteria included cases in which the pathologic results revealed a single characteristic, the presence of invasive mucinous LUAD, or if the first predominant and the second predominant groups could not be distinguished.Categorical variables were compared with the two-tailed Pearson χ 2 test and continuous variables with the Student's t-test. Follow-up was conducted by telephone and other methods. Independent prognostic factors of the second major subtype were determined by the Kaplan-Meier method and log-rank test. The Cox proportional risk regression model was used to analyze the possible prognostic factors.Results: Among 293 patients, the mean age was 61.9 years and 47.1% were male. The results revealed that when the predominant group was the low-grade group, the second predominant groups had no significant influence on overall survival (OS) (P=0.15) but significantly influenced disease free survival (DFS) (P=0.037).Subsequently, when the predominant group was the intermediate-grade group, the second predominant groups significantly influenced OS (P=0.024) but had no significant influence on DFS (P=0.3). Moreover, when the predominant group was the high-grade group, the second predominant groups significantly influenced OS (P=0.033) but had no significant influence on DFS (P=0.31). Conclusions:The independent prognostic effect of the second predominant group was not identified for OS and DFS of lung adenocarcinoma. The effects of the second predominant subtype groups on OS and DFS were not evenly distributed among different predominant subtype groups, and the low-grade second predominant subtype exhibited some protective effects on the middle-grade predominant subtypes.

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“…Most of the previous studies analyzed the risk of patients with lung adenocarcinoma based on the primary histological component or the proportion of second most predominant component [ 18 , 19 ]. Our study was based on the basic distribution of pathological components of the area adjacent pleura, including pathological components type of the area adjacent pleura within lesion, the shortest distance between the largest invasive component area and the pleura, the depth of the largest invasive component area.…”

Section: Discussionmentioning

confidence: 99%

Pathological components and CT imaging analysis of the area adjacent pleura within the pure ground-glass nodules with pleural deformation in invasive lung adenocarcinoma

et al. 2022

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Background Pleural deformation is associated with the invasiveness of lung adenocarcinoma(LAC). Our study focused on the pathological components of the area adjacent pleura in pulmonary pure ground-glass nodules(pGGNs) with pleural deformations(P-pGGNs) confirmed to be invasive LAC without visceral pleural invasion (VPI) pathologically. Methods Computed tomography(CT) imaging features of nodules and pathological components of the area adjacent pleura were analyzed and recorded. Statistical analysis was performed for subgroups of P-pGGNs. Results The 81 enrolled patients with 81 P-pGGNs were finally involved in the analysis. None of solid/micropapillary group and none of VPI was observed, 54 alveoli/lepidics and 27 acinar/papillarys were observed. In P-pGGN with acinar/papillary components of the area adjacent pleura, invasive adenocarcinoma (IAC) was more common compared to minimally invasive adenocarcinoma (MIA, 74.07% vs. 25.93%; p < 0.001). The distance in alveoli/lepidic group was significantly larger (1.50 mm vs. 0.00 mm; p < 0.001) and the depth was significantly smaller (2.00 mm vs. 6.00 mm; p < 0.001) than that in acinar/papillary group. The CT attenuation value, maximum diameter and maximum vertical diameter was valuable to distinguish acinar/papillary group form alveoli/lepidic group(p < 0.05). The type d pleural deformation was the common pleural deformation in IAC(p = 0.028). Conclusions The pathological components of the area adjacent pleura in P-pGGN without VPI confirmed to be invasive LAC could included alveoli/lepidics and acinar/papillarys. Some CT indicators that can identify the pathological invasive components of the area adjacent pleura in P-pGGNs.

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Prognostic impact according to the proportion of the lepidic subtype in stage IA acinar‐predominant lung adenocarcinoma

Cited by 11 publications

References 16 publications

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

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

Prognosis of the second predominant subtype in lung adenocarcinoma: a retrospective single-center cohort study

Pathological components and CT imaging analysis of the area adjacent pleura within the pure ground-glass nodules with pleural deformation in invasive lung adenocarcinoma

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