Prognostic Value of the New International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Lung Adenocarcinoma Classification on Death and Recurrence in Completely Resected Stage I Lung Adenocarcinoma

Hung, Jan Jong; Jeng, Wen–Juei; Chou, Teh-Ying; Hsu, Wen Hu; Wu, Kou-Juey; Huang, Biing-Shiun; Wu, Yue

doi:10.1097/sla.0b013e31828920c0

Cited by 175 publications

(193 citation statements)

References 36 publications

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“…The lung adenocarcinoma classification proposed by IASLC/ATS/ERS divided invasive adenocarcinoma into six groups based on comprehensive histologic subtyping by the predominant pattern: lepidic, acinar, papillary, micropapillary, solid, and variant (1,5). Recent studies showed that the invasive adenocarcinoma subtypes were significantly associated with recurrence and survival (3,4,6). Micropapillary and solid predominant subtypes are known to be poorer prognostic (7)(8)(9)(10); however, the reason for this remains unclear (4,11).…”

Section: Introductionmentioning

confidence: 99%

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Lymph node involvement according to lung adenocarcinoma subtypes: lymph node involvement is influenced by lung adenocarcinoma subtypes

Park¹,

Kim²,

Moon³

et al. 2017

J. Thorac. Dis.

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Backgrounds: Invasive adenocarcinoma subtypes are known to be associated with prognosis; however, the underlying reason remains unclear. To find out the reason, we investigated the possible influence of lymph node (LN) involvement by the constituent histologic subtypes in the tumor and clarified the different prognosis according to the predominant histologic subtypes in the tumor and LN.Methods: A total of 97 consecutive patients who underwent surgical resection for lung invasive adenocarcinoma between February 2009 and December 2015 were included. We analyzed the associations of the histologic subtypes between the tumor and LN and disease-free survival (DFS) according to the histologic subtypes and predicted the histologic subtype in LN involvement using the component ratio of the predominant histologic subtype in the tumor. A P value <0.05 was considered statistically significant.Results: Acinar and papillary subtypes occupied the majority of the predominant histological subtypes (tumor 73.2%, LN 71.1%). The tumor showed significantly more constituent histologic subtypes than LN (P<0.001). Micropapillary and solid predominant subtype were more common in poorer differentiation (tumor P<0.001, LN P=0.001). The predominant histologic subtype in the tumor was not the same as that in LN and micropapillary and solid predominant subtypes were significantly more prone to LN involvement than other subtypes (P<0.001). Regarding the predominant histologic subtypes in the tumor, there was no significant difference in DFS between micropapillary and solid predominant subtypes and other subtypes.However, regarding the predominant histologic subtypes in LN, micropapillary and solid predominant subtypes had significantly lower DFS than other subtypes (P=0.010). Solid predominant subtype had a significant cutoff value for prediction of the predominant histologic subtype in LN using the component ratio of the predominant histologic subtype in the tumor (cutoff value 12.5%, sensitivity 70.0%, specificity 82.4%, area 0.775, P<0.001).Conclusions: The present study presented a possible reason of discrepancies in outcomes according to the lung adenocarcinoma constituent subtypes. Micropapillary and solid predominant subtypes had poorer prognosis than other subtypes, which might be explained by being more prone to LN involvement.

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Section: Introductionmentioning

confidence: 99%

“…Adenocarcinoma is the most common histological type of non-small cell lung cancer (1,4). The lung adenocarcinoma classification is proposed by the International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) (1,5).…”

Section: Introductionmentioning

confidence: 99%

Lymph node involvement according to lung adenocarcinoma subtypes: lymph node involvement is influenced by lung adenocarcinoma subtypes

Park¹,

Kim²,

Moon³

et al. 2017

J. Thorac. Dis.

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“…In a series of 283 stage 1 adenocarcinomas [23], Overall survival for lepidic adenocarcinoma was better than for the other patterns. Recurrence was highest for micropapillary or solid types and lowest for lepidic adenocarcinoma.…”

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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“…As stated previously, studies have shown that solid and micropapillary predominant tumors have the worst prognosis among the histologic subtypes. Additional evidence suggests that the micropapillary pattern may in and of itself be a robust predictor of both prognosis and survival (14,20) and associated with poor outcomes (21,37). Furthermore, it has recently been suggested that the presence or absence of the micropapillary pattern may be an important prognostic indicator and impact survival (32)(33)(34).…”

Section: Issues With Current Histologic Classification Systemmentioning

confidence: 99%

“…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). Overall, among the five invasive ADC subtypes comprised of lepidic, acinar, papillary, micropapillary, and solid predominant patterns, the lepidic predominant group had the best prognosis, papillary and acinar predominant intermediate prognosis, and solid and micropapillary predominant exhibited the poorest.…”

Section: Adenocarcinomamentioning

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 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Lung Adenocarcinoma Classification on Death and Recurrence in Completely Resected Stage I Lung Adenocarcinoma

Cited by 175 publications

References 36 publications

Lymph node involvement according to lung adenocarcinoma subtypes: lymph node involvement is influenced by lung adenocarcinoma subtypes

Lymph node involvement according to lung adenocarcinoma subtypes: lymph node involvement is influenced by lung adenocarcinoma subtypes

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

Surgical pathology of early stage non-small cell lung carcinoma

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