Jung-Jyh Hung1, Yi-Chen Yeh1, Wen-Juei Jeng1, Kou-Juey Wu1, Biing-Shiun Huang1, Yu-Chung Wu1, Teh-Ying Chou1, Wen-Hu Hsu2. 1. All authors: National Yang-Ming University; Jung-Jyh Hung, Yi-Chen Yeh, Kou-Juey Wu, Biing-Shiun Huang, Yu-Chung Wu, Teh-Ying Chou, and Wen-Hu Hsu, Taipei Veterans General Hospital; Wen-Juei Jeng, Chang Gung University and Hospital; and Biing-Shiun Huang, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan. 2. All authors: National Yang-Ming University; Jung-Jyh Hung, Yi-Chen Yeh, Kou-Juey Wu, Biing-Shiun Huang, Yu-Chung Wu, Teh-Ying Chou, and Wen-Hu Hsu, Taipei Veterans General Hospital; Wen-Juei Jeng, Chang Gung University and Hospital; and Biing-Shiun Huang, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan. whhsu@vghtpe.gov.tw.
Abstract
PURPOSE: This study investigated the pattern of recurrence of lung adenocarcinoma and the predictive value of histologic classification in resected lung adenocarcinoma using the new International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification system. PATIENTS AND METHODS: Histologic classification of 573 patients undergoing resection for lung adenocarcinoma was determined according to the IASLC/ATS/ERS classification system, and the percentage of each histologic component (lepidic, acinar, papillary, micropapillary, and solid) was recorded. The pattern of recurrence of those components and their predictive value were investigated. RESULTS: The predominant histologic pattern was significantly associated with sex (P < .01), invasive tumor size (P < .01), T status (P < .01), N status (P < .01), TNM stage (P < .01), and visceral pleural invasion (P < .01). The percentage of recurrence was significantly higher in micropapillary- and solid-predominant adenocarcinomas (P < .01). Micropapillary- and solid-predominant adenocarcinomas had a significantly higher possibility of developing initial extrathoracic-only recurrence than other types (P < .01). The predominant pattern group (micropapillary or solid v lepidic, acinar, or papillary) was a significant prognostic factor in overall survival (OS; P < .01), probability of freedom from recurrence (P < .01), and disease-specific survival (P < .01) in multivariable analysis. For patients receiving adjuvant chemotherapy, solid-predominant adenocarcinoma was a significant predictor for poor OS (P = .04). CONCLUSION: In lung adenocarcinoma, the IASLC/ATS/ERS classification system has significant prognostic and predictive value regarding death and recurrence. Solid-predominant adenocarcinoma was also a significant predictor in patients undergoing adjuvant chemotherapy. Prognostic and predictive information is important for stratifying patients for aggressive adjuvant chemoradiotherapy.
PURPOSE: This study investigated the pattern of recurrence of lung adenocarcinoma and the predictive value of histologic classification in resected lung adenocarcinoma using the new International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification system. PATIENTS AND METHODS: Histologic classification of 573 patients undergoing resection for lung adenocarcinoma was determined according to the IASLC/ATS/ERS classification system, and the percentage of each histologic component (lepidic, acinar, papillary, micropapillary, and solid) was recorded. The pattern of recurrence of those components and their predictive value were investigated. RESULTS: The predominant histologic pattern was significantly associated with sex (P < .01), invasive tumor size (P < .01), T status (P < .01), N status (P < .01), TNM stage (P < .01), and visceral pleural invasion (P < .01). The percentage of recurrence was significantly higher in micropapillary- and solid-predominant adenocarcinomas (P < .01). Micropapillary- and solid-predominant adenocarcinomas had a significantly higher possibility of developing initial extrathoracic-only recurrence than other types (P < .01). The predominant pattern group (micropapillary or solid v lepidic, acinar, or papillary) was a significant prognostic factor in overall survival (OS; P < .01), probability of freedom from recurrence (P < .01), and disease-specific survival (P < .01) in multivariable analysis. For patients receiving adjuvant chemotherapy, solid-predominant adenocarcinoma was a significant predictor for poor OS (P = .04). CONCLUSION: In lung adenocarcinoma, the IASLC/ATS/ERS classification system has significant prognostic and predictive value regarding death and recurrence. Solid-predominant adenocarcinoma was also a significant predictor in patients undergoing adjuvant chemotherapy. Prognostic and predictive information is important for stratifying patients for aggressive adjuvant chemoradiotherapy.
Authors: Song Gao; Seth Stein; Elena N Petre; Waleed Shady; Jeremy C Durack; Carole Ridge; Prasad Adusumilli; Natasha Rekhtman; Stephen B Solomon; Etay Ziv Journal: Cardiovasc Intervent Radiol Date: 2017-08-02 Impact factor: 2.740
Authors: Takashi Eguchi; Kyuichi Kadota; Bernard J Park; William D Travis; David R Jones; Prasad S Adusumilli Journal: Semin Thorac Cardiovasc Surg Date: 2014-09-16