A prognostic nomogram based on a new classification of combined micropapillary and solid components for stage IA invasive lung adenocarcinoma

Abstract

Background We aimed to develop a prognostic nomogram based on a new classification of combined micropapillary and solid components in pathological stage IA invasive lung adenocarcinoma (LUAD). Methods According to the total proportion of solid and micropapillary components (TPSM), the X‐tile software was applied to classify patients into the following three groups: TPSM‐low (TPSM‐L), TPSM‐middle (TPSM‐M), and TPSM‐high (TPSM‐H). The postoperative survival was compared among the three groups. The multivariate Cox regression analysis was performed to identify independent prognostic factors for survival. According to these factors, a nomogram model was developed to provide a personalized prognostic evaluation. Results A total of 595 patients with pathological stage IA invasive LUAD were included in our study. The 5‐year disease‐free survival and overall survival rates in patients with TPSM‐H and TPSM‐M were significantly lower than those with TPSM‐L. The multivariate Cox regression analysis revealed that the TPSM classification was an independent prognostic factor for survival. According to TPSM classification, we developed a nomogram model which had good calibration and reliable discrimination ability to evaluate survival. Conclusions The nomogram based on the combination of micropapillary and solid components has good prognostic value in predicting postoperative recurrence and survival of patients with pathological stage IA invasive LUAD.

Preoperative prognostic prediction for stage I lung adenocarcinomas: Impact of the computed tomography features associated with the new histological grading system

“…Previous studies have integrated T staging with histological subtypes to predict the prognosis of stage I lung cancer ( 4 , 5 , 11 ). However, most of these studies used the histological classification based on the predominant pattern or exploratory reclassification proposed by researchers ( 4 , 5 , 11 ).…”

“…Previous studies have integrated T staging with histological subtypes to predict the prognosis of stage I lung cancer ( 4 , 5 , 11 ). However, most of these studies used the histological classification based on the predominant pattern or exploratory reclassification proposed by researchers ( 4 , 5 , 11 ). To our knowledge, few previous studies have combined the new IASLC grading system and T staging, especially clinical T staging, to predict the DFS of stage I lung adenocarcinoma patients.…”

“…However, patients with the same T stage are histologically heterogeneous. Several attempts have been made to integrate histological subtypes and T stages to improve prognostic prediction for patients with stage I lung adenocarcinoma (LUAD) ( 4 , 5 ). A new histological grading scheme was proposed by the Pathology Committee of the International Association for the Study of Lung Cancer (IASLC) in 2020 and recommended by the fifth edition of the World Health Organization (WHO) classification of thoracic tumors in 2021.…”

Micropapillary or solid component predicts worse prognosis in pathological IA stage lung adenocarcinoma: A meta-analysis

“…The Medline, EMBASE, Web of Science and CNKI electronic databases were searched from inception to December 31, 2022. The following key words were used during the search: lung, Sumiyoshi [24] 2013 Japan 256 >5% -MIP+ DFS, OS E Hirano [25] 2014 Japan 218 >5% -MIP+ OS E Luo [26] 2017 China 2504 -Predominant SD+ DFS, OS R Wang [27] 2018 China 1965 >5% >5% MIP+/SD+ DFS, OS R Chen C [28] 2020 China 77 >5% >5% MIP+, SD+ OS E Chen D [29] 2020 China 1543 Predominant -MIP+ DFS, OS E Chen D [29] 2020 China 714 Predominant -MIP+ DFS, OS E Zhang [30] 2020 China 90 Predominant Predominant MIP+/SD+ OS R Peng [31] 2021 China 422 >5% >5% MIP+/SD+, MIP+, SD+ DFS, OS R/E Choi [33] 2021 Korea 299 0-5% 0-5% MIP+/SD+ DFS R Jeon [34] 2021 Republic of Korea 429 >20% >20% MIP+/SD+ DFS, OS R Zhai [35] 2021 China 484 >5% >5% MIP+/SD+ DFS, OS R Chen Y [32] 2021 China 314 >5% >5% MIP+, SD+ DFS, OS R Zhang [36] 2021 China 435 --MIP+, SD+ DFS, OS R Bertoglio [37] 2022 Italy 326 >5% >5% MIP+/SD+ DFS, OS E Chen C [38] 2022 China 814 >1% >1% MIP+, SD+ DFS R Huang [39] 2022 China 595 >10% >10% MIP+/SD+ DFS, OS R Jin [40] 2022 China 321 >5% >5% MIP+/SD+ DFS R Okubo [42] 2022 Japan 380 Predominant Predominant MIP+, SD+ DFS R Lu [41] 2022 China 306 --MIP+/SD+ DFS, OS R DFS = disease-free survival, E = estimated, HR = hazard ratio, MIP = micropapillary, NOS = Newcastle-Ottawa Scale, NR = not reported, OS = overall survival, R = reported, SD = solid.…”

“…A total of 19 studies were eventually included in this meta-analysis. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]…”