BACKGROUND: Although grading has prognostic significance for many tumor types, a prognostically significant grading system for lung adenocarcinoma has not yet been established. The aim of this study was to evaluate histologic characteristics included in tumor grading systems, establish optimal cutoff values that have the strongest association with overall survival, and develop a grading system incorporating the histopathologic characteristics that the authors found to have prognostic significance in patients with lung adenocarcinoma. METHODS: The authors studied lung adenocarcinomas from 85 consecutive patients, and evaluated the percentage of solid pattern (as a reflection of tumor architecture), the degree of cytologic atypia, and the mitotic count. RESULTS: In univariate analysis, overall survival was associated significantly with sex (P = .045), age (P = .0008), tumor status (P < .0001), lymph node status (P = .02), solid pattern (P = .046), and cytologic atypia (P = .01), but not with mitotic count (P = .26). On the basis of optimal cutoff values, the authors found that a solid pattern > or = 90% and severe cytologic atypia were the best discriminators of worse outcome. A grading score, computed as the sum of the architecture score and cytologic atypia score (2 = well differentiated, 3 = moderately differentiated, 4 = poorly differentiated), was a significant predictor of overall survival in univariate analysis (median overall survival times, 72.4, 39.5, and 8.7 months for well, moderately, and poorly differentiated adenocarcinoma, respectively; P = .0001). Moreover, grading was an independent predictor of survival in multivariate analysis (P = .002). CONCLUSIONS: The authors describe a grading system that incorporates the percentage of solid pattern and degree of the cytologic atypia that is an independent predictor of survival in patients with lung adenocarcinoma. Copyright 2009 American Cancer Society.
BACKGROUND: Although grading has prognostic significance for many tumor types, a prognostically significant grading system for lung adenocarcinoma has not yet been established. The aim of this study was to evaluate histologic characteristics included in tumor grading systems, establish optimal cutoff values that have the strongest association with overall survival, and develop a grading system incorporating the histopathologic characteristics that the authors found to have prognostic significance in patients with lung adenocarcinoma. METHODS: The authors studied lung adenocarcinomas from 85 consecutive patients, and evaluated the percentage of solid pattern (as a reflection of tumor architecture), the degree of cytologic atypia, and the mitotic count. RESULTS: In univariate analysis, overall survival was associated significantly with sex (P = .045), age (P = .0008), tumor status (P < .0001), lymph node status (P = .02), solid pattern (P = .046), and cytologic atypia (P = .01), but not with mitotic count (P = .26). On the basis of optimal cutoff values, the authors found that a solid pattern > or = 90% and severe cytologic atypia were the best discriminators of worse outcome. A grading score, computed as the sum of the architecture score and cytologic atypia score (2 = well differentiated, 3 = moderately differentiated, 4 = poorly differentiated), was a significant predictor of overall survival in univariate analysis (median overall survival times, 72.4, 39.5, and 8.7 months for well, moderately, and poorly differentiated adenocarcinoma, respectively; P = .0001). Moreover, grading was an independent predictor of survival in multivariate analysis (P = .002). CONCLUSIONS: The authors describe a grading system that incorporates the percentage of solid pattern and degree of the cytologic atypia that is an independent predictor of survival in patients with lung adenocarcinoma. Copyright 2009 American Cancer Society.
Authors: Ahmedin Jemal; Rebecca Siegel; Elizabeth Ward; Taylor Murray; Jiaquan Xu; Michael J Thun Journal: CA Cancer J Clin Date: 2007 Jan-Feb Impact factor: 508.702
Authors: G P Murphy; C Busch; P A Abrahamsson; J I Epstein; J E McNeal; G J Miller; F K Mostofi; R B Nagle; S Nordling; C Parkinson Journal: Scand J Urol Nephrol Suppl Date: 1994
Authors: Kyuichi Kadota; Christos Colovos; Kei Suzuki; Nabil P Rizk; Mark P S Dunphy; Emily C Zabor; Camelia S Sima; Akihiko Yoshizawa; William D Travis; Valerie W Rusch; Prasad S Adusumilli Journal: Ann Surg Oncol Date: 2012-05-30 Impact factor: 5.344
Authors: Kyuichi Kadota; Kei Suzuki; Christos Colovos; Camelia S Sima; Valerie W Rusch; William D Travis; Prasad S Adusumilli Journal: Mod Pathol Date: 2011-10-07 Impact factor: 7.842
Authors: Maristela L Onozato; Alexandra E Kovach; Beow Y Yeap; Vicente Morales-Oyarvide; Veronica E Klepeis; Swathi Tammireddy; Rebecca S Heist; Eugene J Mark; Dora Dias-Santagata; A John Iafrate; Yukako Yagi; Mari Mino-Kenudson Journal: Am J Surg Pathol Date: 2013-02 Impact factor: 6.394
Authors: Xiaohong Wang; Jonathan E Schoenhals; Ailin Li; David R Valdecanas; Huiping Ye; Fenglin Zang; Chad Tang; Ming Tang; Chang-Gong Liu; Xiuping Liu; Sunil Krishnan; James P Allison; Padmanee Sharma; Patrick Hwu; Ritsuko Komaki; Willem W Overwijk; Daniel R Gomez; Joe Y Chang; Stephen M Hahn; Maria Angelica Cortez; James W Welsh Journal: Cancer Res Date: 2016-11-07 Impact factor: 12.701