| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Murakami, Shuji Ito, Hiroyuki Tsubokawa, Norifumi Mimae, Takahiro Sasada, Shinsuke Yoshiya, Tomoharu Miyata, Yoshihiro Yokose, Tomoyuki Okada, Morihito Nakayama, Haruhiko |
| Description |
Country affiliation: Japan Author Affiliation: Murakami S ( Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.); Ito H ( Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.); Tsubokawa N ( Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.); Mimae T ( Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.); Sasada S ( Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.); Yoshiya T ( Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.); Miyata Y ( Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.); Yokose T ( Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan.); Okada M ( Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.); Nakayama H ( Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan. Electronic address: nakayama-h@kcch.jp.) |
| Abstract |
OBJECTIVES: We analyzed and validated the prognostic utility of the new International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) for clinical stage IA lung adenocarcinoma (ADC) classification of adenocarcinoma (ADC). METHODS: We retrospectively reviewed 347 patients with clinical stage IA nonmucinous ADC, who had undergone complete resection. The histological subtype was classified according to the predominant subtype, as proposed by the new IASLC/ATS/ERS ADC classification. RESULTS: The histopathological subtypes, defined according to the new IASLC/ATS/ERS ADC classification, were ADC in situ (AIS) in 56 patients (16.1%), minimally invasive ADC (MIA) in 15 (4.3%), lepidic-predominant ADC in 109 (31.4%), papillary-predominant ADC in 70 (20.2%), acinar-predominant ADC in 61 (17.6%), solid-predominant ADC in 30 (8.6%), and micropapillary-predominant ADC in 6 (1.7%). The 5-year disease-free survival (DFS) rate was 100% for both AIS and MIA. All cases of recurrence involved invasive ADC. The 5-year DFS for lepidic-predominant ADC was 99.0%; acinar-predominant ADC, 82.4%; papillary-predominant ADC, 80.8%; solid-predominant ADC, 73.6%; and micropapillary-predominant ADC, 33.3%. The predominant subtype of ADC was significantly correlated with DFS (P<0.0001). Multivariate analysis indicated that the pathological stage was an independent predictor of DFS (P=0.031). Other independent predictors of increased risk of recurrence were the presence of vascular or lymphatic invasion (HR=4.96, P=0.001), and a pathological stage more advanced than IB (HR=2.87, P=0.010). The coincidence between the clinical stage and pathological stage was 79.8%. The stage migration was found in 53.3% of solid-predominat ADC and in 83.3% of micropapillary-predominant ADC. CONCLUSION: The new IASLC/ATS/ERS ADC classification has prognostic value in predicting the recurrence and survival of patients with clinical stage IA ADC. The frequency of stage migration was found in more than half of solid and micropapillary predominant ADCs. |
| File Format |
HTM / HTML |
| ISSN |
01695002 |
| Issue Number |
2 |
| Volume Number |
90 |
| e-ISSN |
18728332 |
| Journal |
Lung Cancer |
| Language |
English |
| Publisher |
Elsevier |
| Publisher Date |
2015-11-01 |
| Publisher Place |
Ireland |
| Access Restriction |
One Nation One Subscription (ONOS) |
| Subject Keyword |
Discipline Oncology Adenocarcinoma Pathology Lung Neoplasms Adult Aged Aged, 80 And Over Disease-free Survival Female Humans Kaplan-meier Estimate Male Middle Aged Neoplasm Recurrence, Local Neoplasm Staging Methods Prognosis Retrospective Studies Journal Article |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Pulmonary and Respiratory Medicine Cancer Research Oncology |
