Prognostic Affect of Predominant Histologic Subtypes in Resected Pulmonary Adenocarcinoma Predominant Subtypes of Pulmonary Adenocarcinoma

Abstract

Background:Predominant histologic subtypes have been reported as predictors of survival of patients with pulmonary adenocarcinoma.Aims:To evaluate the predictive value of histologic classification in resected lung adenocarcinoma using the classification systems proposed by the International Association for the Study of Lung Cancer, American Thoracic Society, European Respiratory Society, and World Health Organization (2015).Study Design:Cross-sectional study.Methods:The histologic classification of a large cohort of 491 patients with resected lung adenocarcinoma (stages I-III) was retrospectively analyzed. The tumors were classified according to their predominant component (lepidic, acinar, papillary, solid, micropapillary, and mucinous), and their predictive values were assessed for clinicopathologic characteristics and overall survival.Results:The patient cohort comprised 158 (32.2%) patients with solid predominant, 150 (30.5%) with acinar predominant, 80 (16.3%) with papillary predominant, 75 (15.3%) with lepidic predominant, 22 (4.5%) with mucinous, and 5 (1.0%) with micropapillary subtype, and 1 (0.2%) with adenocarcinoma in situ. Overall 5-year survival of 491 patients was found to be 51.8%. Patients with lepidic, acinar, and mucinous adenocarcinoma had 70.9%, 59.0%, and 66.6% 5-year survival, respectively, and there was no statistically significant difference between them. Whereas patients with solid, papillary, and micropapillary predominant adenocarcinoma had 41.0%, 40.5%, and 0.0% 5-year survival, respectively. Compared to other histologic subtypes, patients with solid and papillary predominant adenocarcinoma had significantly lower survival than those with lepidic (p<0.001, p=0.002), acinar (p<0.001, p=0.008), and mucinous (p=0.048, p=0.048) subtypes, respectively. The survival difference between patients with solid subtype and those with papillary subtype was not statistically significant (p=0.67).Conclusion:Solid and papillary histologic subtypes are poor prognostic factors in resected invasive lung adenocarcinoma.

Adenocarcinoma of High-Grade Patterns Associated with Distinct Outcome of First-Line Chemotherapy or EGFR-TKIs in Patients of Relapsed Lung Cancer

“…We found a higher incidence of solid and micropapillary predominant adenocarcinoma compared to that in the open-source data. 14 , 30 Meanwhile, patients with lepidic-predominant lung adenocarcinoma were lower in our study than in previous reports, 10 , 31 reiterating adenocarcinoma with high-grade patterns had a higher risk of recurrence than those with other adenocarcinoma subgroups. 11 …”

Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer

“…However, other studies reported that adenocarcinoma, as a poor prognostic determinant in resected lung cancer, appeared to have a higher recurrence rate than non-adenocarcinoma. 19,20 It might be explained that for postoperative patients of stage I, adenocarcinoma was more likely to have distant metastasis, while squamous cell carcinoma was more likely to have local recurrence. 21 The T stage has always been an independent risk influence affecting prognosis after stage I NSCLC.…”