A Grading System for Invasive Pulmonary Adenocarcinoma: A Proposal From the International Association for the Study of Lung Cancer Pathology Committee.
In: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, Jg. 15 (2020-10-01), Heft 10, S. 1599-1610
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Zugriff:
Introduction: A grading system for pulmonary adenocarcinoma has not been established. The International Association for the Study of Lung Cancer pathology panel evaluated a set of histologic criteria associated with prognosis aimed at establishing a grading system for invasive pulmonary adenocarcinoma.
Methods: A multi-institutional study involving multiple cohorts of invasive pulmonary adenocarcinomas was conducted. A cohort of 284 stage I pulmonary adenocarcinomas was used as a training set to identify histologic features associated with patient outcomes (recurrence-free survival [RFS] and overall survival [OS]). Receiver operating characteristic curve analysis was used to select the best model, which was validated (n = 212) and tested (n = 300, including stage I-III) in independent cohorts. Reproducibility of the model was assessed using kappa statistics.
Results: The best model (area under the receiver operating characteristic curve [AUC] = 0.749 for RFS and 0.787 for OS) was composed of a combination of predominant plus high-grade histologic pattern with a cutoff of 20% for the latter. The model consists of the following: grade 1, lepidic predominant tumor; grade 2, acinar or papillary predominant tumor, both with no or less than 20% of high-grade patterns; and grade 3, any tumor with 20% or more of high-grade patterns (solid, micropapillary, or complex gland). Similar results were seen in the validation (AUC = 0.732 for RFS and 0.787 for OS) and test cohorts (AUC = 0.690 for RFS and 0.743 for OS), confirming the predictive value of the model. Interobserver reproducibility revealed good agreement (k = 0.617).
Conclusions: A grading system based on the predominant and high-grade patterns is practical and prognostic for invasive pulmonary adenocarcinoma.
(Copyright © 2020 International Association for the Study of Lung Cancer. All rights reserved.)
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A Grading System for Invasive Pulmonary Adenocarcinoma: A Proposal From the International Association for the Study of Lung Cancer Pathology Committee.
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| Autor/in / Beteiligte Person: | Moreira, AL ; Ocampo, PSS ; Xia, Y ; Zhong, H ; Russell, PA ; Minami, Y ; Cooper, WA ; Yoshida, A ; Bubendorf, L ; Papotti, M ; Pelosi, G ; Lopez-Rios, F ; Kunitoki, K ; Ferrari-Light, D ; Sholl, LM ; Beasley, MB ; Borczuk, A ; Botling, J ; Brambilla, E ; Chen, G ; Chou, TY ; Chung, JH ; Dacic, S ; Jain, D ; Hirsch, FR ; Hwang, D ; Lantuejoul, S ; Lin, D ; Longshore, JW ; Motoi, N ; Noguchi, M ; Poleri, C ; Rekhtman, N ; Tsao, MS ; Thunnissen, E ; Travis, WD ; Yatabe, Y ; Roden, AC ; Daigneault, JB ; Wistuba, II ; Kerr, KM ; Pass, H ; Nicholson, AG ; Mino-Kenudson, M |
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| Zeitschrift: | Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, Jg. 15 (2020-10-01), Heft 10, S. 1599-1610 |
| Veröffentlichung: | 2016- : New York, NY : Elsevier ; <i>Original Publication</i>: Hagerstown, MD : Lippincott Williams & Wilkins, c2006-, 2020 |
| Medientyp: | academicJournal |
| ISSN: | 1556-1380 (electronic) |
| DOI: | 10.1016/j.jtho.2020.06.001 |
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