Prognostic value of the new IASLC/ATS/ERS classification of clinical stage IA lung adenocarcinoma

Murakami, Shuji; Ito, Hiroyuki; Tsubokawa, Norifumi; Mimae, Takahiro; Sasada, Shinsuke; Yoshiya, Tomoharu; Miyata, Yoshihiro; Yokose, Tomoyuki; Okada, Morihito; Nakayama, Haruhiko

doi:10.1016/j.lungcan.2015.06.022

Cited by 67 publications

(66 citation statements)

References 23 publications

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“…The grouping of lepidic adenocarcinoma with the intermediate group to contrast the high-grade group for statistical significance underscores the prognostic importance of the lepidic predominant adenocarcinoma as an early stage indolent tumour in the 2011 IASLC classification [20]. The favourable prognosis of the predominant lepidic pattern tumour is a major component of the prognostic classification.…”

Section: Prognosis Across All Stagesmentioning

confidence: 91%

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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Section: Prognosis Across All Stagesmentioning

confidence: 91%

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

Borczuk

2016

Eur Respir Rev

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“…Thus, the cytological and histological types (based on morphological classification with conventional routine staining) closely correlated. On the other hand, after publication of the IASLC/ATS/ERS classification, the subclassification of ADC was reported to have significant prognostic value [3][4][5]. Rodriguaez et al [7] attempted to distinguish the ADC subtypes using cytological specimens; they noted that architectural and nuclear features may be helpful, particularly in distinguishing the solid pattern from other patterns; however, the cytological features of the lung ADC subtypes proposed by the IASLC/ATS/ERS classification overlap.…”

Section: Discussionmentioning

confidence: 99%

“…The guidelines recommend the classification of the major adenocarcinoma (ADC) subtypes according to the predominant histological pattern (primary pattern), and the estimation of the percentage of the other ADC patterns that may be present in a resected specimen (in increments of 5%; secondary pattern). Some investigators have used analyzed the impact of the sub-classification on the prognosis of the major subtypes of resected lung ADC, which include acinar, solid, papillary, lepidic and micropapillary [3][4][5]. In those studies, solid and micropapillary predominant ADC were shown to have significantly worse prognoses than the other predominant subtypes; thus, they were considered to have significant value in predicting death and recurrence in the IASLC/ATS/ERS ADC classification system.…”

Section: Introductionmentioning

confidence: 99%

The Cytomorphological Characteristics of Non-small Cell Lung Cancer are Associated with Its Radiological Features

Tanaka¹,

Sakamoto²,

Suzuki³

et al. 2017

J Cytol Histol

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Background: Distinguishing the histological subtype of lung cancer is extremely important because chemotherapy agents may have different chemotherapeutic effects in different histological subtypes. This study retrospectively evaluated the characteristic differences in the cytomorphological and radiological features of nonsmall cell lung cancer.Methods: This study population included 50 lung cancer patients who were diagnosed based on bronchoscopic biopsy findings and underwent surgery from April 2011 to May 2016. Cyotological specimens (Papanicolaou's staining) were separately analyzed by two experienced cytotechnicians. The associations between the clinicopathological data, as well as the preoperative radiological features on computed tomography (CT) and positron emission tomography (PET) and cytomorphological analyses were analyzed.Results: Forty-five specimens were analyzed (adenocarcinoma [ADC] [n=38], squamous cell carcinomas [SQCC] [n=7]). The ADCs were cytomorphologically sub-classified as follows: acinar (n=25), solid (n=10), lepidic (n=2) and papillary (n=1). Among specimens with a solid pattern of ADC, there was a significantly greater percentage of samples with a necrotic background (50%), predominant 3D clusters (100%) and conspicuous nucleoli (80%) compared to specimens with a nonsolid pattern of ADC. The CT images of patients with solid ADC (90%) and SQCC (100%) tended to show solid nodules on CT. On PET, the maximum standardized uptake values at 120 minutes in solid ADC and SQCC were significantly higher in comparison to nonsolid ADC (12.8 ± 6.1 and 17.2 ± 7.3 versus 8.9 ± 4.4, respectively). Conclusions:The differentiation of the cytomorphological characteristics might predict the values of radiological features, and thereby provide information that can be used when determining the treatment strategies.

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“…This new classification system stratifies tumors into morphological subgroups that have biologic relevance and may impact clinical decision-making. The prognostic significance of the histological classification system proposed by the IASLC has been validated by numerous studies and correlated with patient outcomes (3,7). While patients with AIS and MIA are reported to have 100% five-year disease free survival (DFS), the various histologic subtypes are associated with significant differences in DFS and overall survival (OS) (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Section: Adenocarcinomamentioning

confidence: 99%

“…This classification scheme is based almost exclusively on studies of small ADCs less than three centimeters (2-6). As such, while the prognostic significance of the classification in larger tumors has not been well validated, its value has otherwise been supported in several studies focusing on smaller tumors (7). As with any classification system, additional issues potentially impacting prediction of tumor behavior and prognosis have arisen and need to be addressed.…”

Section: Introductionmentioning

confidence: 99%

Surgical pathology of early stage non-small cell lung carcinoma

2016

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While limited resection appears to be suitable for tumors with a ground glass radiographic appearance, which typically correspond to adenocarcinoma in situ (MIS) or minimally invasive adenocarcinoma (MIA) histologically, the role of sublobar resection in radiographic solid tumors is not as clear, and the impact of histologic subtypes with a poor prognosis needs further evaluation. Squamous cell carcinoma (SCC) has not been as extensively studied and the current classification lacks subclassification with significant prognostic information.

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Prognostic value of the new IASLC/ATS/ERS classification of clinical stage IA lung adenocarcinoma

Cited by 67 publications

References 23 publications

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

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

The Cytomorphological Characteristics of Non-small Cell Lung Cancer are Associated with Its Radiological Features

Surgical pathology of early stage non-small cell lung carcinoma

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