C-h Xu1, W Wang2, Y Wei1, H-d Hu3, J Zou3, J Yan4, L-k Yu5, R-s Yang6, Y Wang7. 1. Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, China; Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, Jiangsu 210029, China. 2. Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, China. 3. Department of Pathology, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, China. 4. MOE Key Laboratory, Model Animal Research Center, Nanjing University, Nanjing, Jiangsu 210061, China. 5. Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, China; Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, Jiangsu 210029, China. Electronic address: yulike_doctor@126.com. 6. Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, China. 7. Department of Radiology, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, China.
Abstract
BACKGROUND: Patients with pathological stage IB lung adenocarcinoma have a variable prognosis, even if received the same treatment. This study investigated the prognostic value of the new International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) lung adenocarcinoma classification in resected stage IB lung adenocarcinoma. METHODS: We identified 276 patients with pathological stage IB adenocarcinoma who had undergone surgical resection at the Nanjing Chest Hospital between 2005 and 2010. The histological subtypes of all patients were classified according to the 2011 IASLC/ATS/ERS international multidisciplinary lung adenocarcinoma classification. Kaplan-Meier and Cox regression analyses were used to analyze the correlation between the IASLC/ATS/ERS classification and patients' prognosis. RESULTS: Two hundred and seventy-six patients with pathological stage IB adenocarcinoma had an 86.2% 5-year overall survival (OS) and 80.4% 5-year disease-free survival (DFS). Patients with micropapillary and solid predominant tumors had a significantly worse OS and DFS as compared to those with other subtypes predominant tumors (p = 0.003 and 0.001). Multivariate analysis revealed that the new classification was an independent prognostic factor for both OS and DFS of pathological stage IB adenocarcinoma (p = 0.009 and 0.003). CONCLUSION: Our study revealed that the new IASLC/ATS/ERS classification was an independent prognostic factor of pathological stage IB adenocarcinoma. This new classification is valuable of screening out high risk patients to receive postoperative adjuvant therapy.
BACKGROUND:Patients with pathological stage IB lung adenocarcinoma have a variable prognosis, even if received the same treatment. This study investigated the prognostic value of the new International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) lung adenocarcinoma classification in resected stage IB lung adenocarcinoma. METHODS: We identified 276 patients with pathological stage IB adenocarcinoma who had undergone surgical resection at the Nanjing Chest Hospital between 2005 and 2010. The histological subtypes of all patients were classified according to the 2011 IASLC/ATS/ERS international multidisciplinary lung adenocarcinoma classification. Kaplan-Meier and Cox regression analyses were used to analyze the correlation between the IASLC/ATS/ERS classification and patients' prognosis. RESULTS: Two hundred and seventy-six patients with pathological stage IB adenocarcinoma had an 86.2% 5-year overall survival (OS) and 80.4% 5-year disease-free survival (DFS). Patients with micropapillary and solid predominant tumors had a significantly worse OS and DFS as compared to those with other subtypes predominant tumors (p = 0.003 and 0.001). Multivariate analysis revealed that the new classification was an independent prognostic factor for both OS and DFS of pathological stage IB adenocarcinoma (p = 0.009 and 0.003). CONCLUSION: Our study revealed that the new IASLC/ATS/ERS classification was an independent prognostic factor of pathological stage IB adenocarcinoma. This new classification is valuable of screening out high risk patients to receive postoperative adjuvant therapy.