The Clinical Impact of Solid and Micropapillary Patterns in Resected Lung Adenocarcinoma

Yanagawa, Naoki; Shiono, Satoshi; Abiko, Masami; Katahira, Masato; Osakabe, Mitsumasa; Ogata, Shinya

doi:10.1016/j.jtho.2016.06.014

Cited by 90 publications

(80 citation statements)

References 14 publications

(17 reference statements)

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“…In conclusion, Yanagawa's study (10) indicated that patients with micropapillary and/or solid patterns had a worse prognosis, regardless of the predominance of the patterns. A future study is necessary to confirm whether these histological patterns are worse prognostic factors in…”

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confidence: 84%

“…Yanagawa et al (10) investigated the proportion of solid and micropapillary patterns in resected lung adenocarcinomas and validated the relationship between the proportion and the clinicopathological backgrounds, including prognosis. They examined a total of 531 resected lung adenocarcinomas and classified the cases into the following five subgroups according to the proportion of solid and/or micropapillary patterns: (I) both patterns absent (S−/MP−); (II) solid predominant (S pre); (III) micropapillary predominant (MP pre); (IV) solid pattern present (≥5%) but not predominant and micropapillary absent (S+ not pre/MP−); and (V) MP pattern present (≥5%) but not predominant (MP+ not pre).…”

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confidence: 99%

“…In Yanagawa's study (10), the multivariate analysis was performed only for patients with stage I disease, and showed that the S−/MP− subgroup tended to have higher RFS and OS rates than the other groups. Other studies have also investigated lung adenocarcinomas with solid and/or micropapillary patterns in patients with early-stage disease.…”

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confidence: 99%

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Prognostic contribution of non-predominant solid and micropapillary components in lung adenocarcinomas

2017

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Prognostic contribution of non-predominant solid and micropapillary components in lung adenocarcinomas

2017

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“…Patterns were assessed in a semiquantitative manner to the nearest 5% level, and a predominant pattern was designated for each tumor. We also evaluated the presence of nonpredominant solid, micropapillary and lepidic subtypes, because these subtypes have a prognostic impacts even when their patterns are not predominant . The tumors were classified using the architectural grading system according to histologic subtype as follows: grade 1 (low grade), adenocarcinoma in situ, minimally invasive adenocarcinoma, or lepidic‐predominant adenocarcinoma; grade 2 (intermediate grade), acinar‐ or papillary‐predominant type; grade 3 (high grade), micropapillary‐ or solid‐predominant patterns.…”

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confidence: 99%

Emphysema is associated with the aggressiveness of COPD‐related adenocarcinomas

Lim

Shin

Lim

et al. 2020

Clinical Respiratory J

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Objectives To compare the differences in radiologic and pathologic features of surgically resected chronic obstructive pulmonary disease (COPD)‐related adenocarcinomas according to the presence of emphysema. Methods A total of 216 smokers with surgically resected lung adenocarcinoma were included in this retrospective study, and 102 patients were diagnosed with COPD. We classified COPD patients as emphysematous or non‐emphysematous group based on the emphysema severity on computed tomography (CT) and evaluated the differences in the CT and pathologic features between the two groups. The relationship between emphysema and disease‐free survival was assessed using a Kaplan–Meier curve. Results Lung adenocarcinomas in emphysema group presented a more aggressive pathologic grade and higher prevalence of solid lesions (vs subsolid lesions) on CT than those in non‐emphysematous group (P = 0.006 and <0.001, respectively). After adjustment for age, sex, smoking pack‐years and tumor size, emphysema group had a greater risk for higher histologic grade and higher prevalence of solid lesions than non‐emphysema group (odds ratio, 3.445; 95% confidence interval, 1.124‐10.564; P = 0.030, odds ratio, 6.192; 95% confidence interval, 1.804‐21.254; P = 0.004, respectively). Kaplan‐Meier survival curves showed that patients with emphysema had significantly impaired disease‐free survival compared with those without emphysema (median disease‐free survival = 37.0 vs 57.5 months, P = 0.038). Conclusion Adenocarcinomas in emphysema‐present COPD had more aggressive features of pathology and CT findings, and worse disease‐free survival than those without emphysema. These findings might provide an insight into the different pathobiology and prognostic implications of lung adenocarcinomas according to the presence of emphysema in patients with COPD.

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“…It has been effectively used to predict the prognosis of lung adenocarcinoma patients. The classification was established on the most predominant subtype presented: invasive adenocarcinoma with solid (SOL) or micropapillary (MIP) carcinoma, which is associated with a poor survival (13)(14)(15)(16)(17). Both adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) have nearly 100% postsurgical survival, and limited resection is appropriate for those patients.…”

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Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

et al. 2018

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Background: This study aimed to evaluate the prognostic difference between limited resection and lobectomy among elderly patients with small size lung adenocarcinoma. Methods: A total of 666 patients >65 years old with stage I lung adenocarcinoma and tumor size ≤2 cm were included. The patient survival was evaluated by disease-free survival (DFS) and overall survival (OS). Results: No DFS or OS advantage was found between the lobectomy and wedge resection groups when tumor sizes were ≤1 cm (DFS, P=0.112; OS, P=0.294). The wedge resection group had a significantly worse OS (P=0.041) than that in the lobectomy group when tumor sizes were >1 cm and ≤2 cm. Conclusions: We conclude that wedge resection may be a reasonable surgical choice for elderly patients with tumor sizes ≤1 cm. The International Association Study of Lung Cancer (IASLC), the American Thoracic Society (ATS) and the European Respiratory Society (ERS) proposed a new edition of the lung adenocarcinoma classification system in 2011 (12). It has been effectively used to predict the prognosis of lung adenocarcinoma patients. The classification was established on the most predominant subtype presented: invasive adenocarcinoma with solid (SOL) or micropapillary (MIP) carcinoma, which is associated with a poor survival (13)(14)(15)(16)(17). Both adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) have nearly 100% postsurgical survival, and limited resection is appropriate for those patients. However, to date, whether limited resection is adequate for early-stage invasive lung adenocarcinoma patients, especially for patients who are older than 65, has not been thoroughly studied (8). In this study, a large cohort investigation was carried out to determine the correlation between surgical procedures and postoperative survival among elderly lung adenocarcinoma patients with tumor sizes ≤2 cm. Our study may help to design personalized surgical strategies for older patients. Methods Patient cohortThe retrospective study was permitted by the Institutional Review Board of Shanghai Chest Hospital at Shanghai Jiao Tong University and was performed in compliance with the guidelines of clinical research [ethic approval ID: KS(P)1802].We retrospectively reviewed patients who underwent surgical resection at our hospital between January 2009 and March 2015. The inclusion criteria were patients 65 years old or older, presentation of a single lung nodule, the postsurgical pathological specimen examination validated that the tumor size was less than or equal to 2 cm, there was no lymph node invasion, and there was no distant organ metastasis. The exclusion criteria included patients who had a history of malignancy, had multiple nodules, received neoadjuvant chemotherapy AIS or MIA. Invasive adenocarcinoma variants (such as mucinous, enteric or fetal morphologies) were also excluded for low incidence. Finally, this study included a total of 666 patients.In our clinical practice, patients with the following characteristics were treated with limited resect...

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The Clinical Impact of Solid and Micropapillary Patterns in Resected Lung Adenocarcinoma

Abstract: Patients with S and/or MP patterns have a poorer prognosis even if their patterns are not predominant. The S and/or MP patterns must be treated at the time of diagnosis.

Cited by 90 publications

References 14 publications

Prognostic contribution of non-predominant solid and micropapillary components in lung adenocarcinomas

Prognostic contribution of non-predominant solid and micropapillary components in lung adenocarcinomas

Emphysema is associated with the aggressiveness of COPD‐related adenocarcinomas

Prognosis of limited resection versus lobectomy in elderly patients with invasive lung adenocarcinoma with tumor size less than or equal to 2 cm

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