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. 2022 Aug 10;22(1):875.
doi: 10.1186/s12885-022-09973-8.

The prognostic impact of lung adenocarcinoma predominance classification relating to pathological factors in lobectomy, the Japanese Joint Committee of Lung Cancer Registry Database in 2010

Hiroyuki Ito  1 , Hiroshi Date  2 , Yasushi Shintani  3 , Etsuo Miyaoka  4 , Ryoichi Nakanishi  5 , Mitsutaka Kadokura  6 , Shunsuke Endo  7 , Masayuki Chida  8 , Ichiro Yoshino  9 , Hidemi Suzuki  9 ; Japanese Joint Committee of Lung Cancer Registry
Affiliations

The prognostic impact of lung adenocarcinoma predominance classification relating to pathological factors in lobectomy, the Japanese Joint Committee of Lung Cancer Registry Database in 2010

Hiroyuki Ito et al. BMC Cancer. .

Abstract

Objective: We studied the prognosis and clinicopathological background of lung adenocarcinoma predominance among patients who underwent lobectomy using data from the Japanese Joint Committee of Lung Cancer Registry.

Methods: Two thousand eight hundred sixty-three cases were extracted. Recurrence free survival (RFS) rates, overall survival (OS) rates and clinicopathological factors and epidermal growth factor receptor (EGFR) mutation status were examined.

Results: Median follow-up period was 65.5 months. Adenocarcinoma predominance was sub-grouped according to OS and RFS rate. In pathological stage I, 5-year RFS and OS rates were respectively 92.2% and 95.8% in group A (adenocarcinoma-in-situ + minimally invasive adenocarcinoma), 89.3% and 92.1% in group B (lepidic), 79.2% and 89.7% in group C (papillary + acinar + variants) and 69.0% and 79.0% in group D (solid + micropapillary). In pathological stage II + IIIA, they were, 43.6% and 72.4% in B, 39.5% and 66.9% in C and 31.0% and 53.7% in D. Group D showed significant worst outcome both in stage I and II + IIIA. Up stage rate from clinical stage I to pathological stage II + IIIA was 0.0%, 3.7%, 15.9% and 33.3%. The frequency of lymph-vessel, vascular, pleura invasion and positive EGFR mutation were 0.0%, 0.0%, 0.0% and 57.1% in group A, 15.6%, 10.0%, 12.1% and 55.1% in B, 36.6%, 31.8%, 29.7% and 44.9% in C, 50.2%, 57.8%, 38.9% and 21.3% in D. In group D, lymph-vessel, vascular and pleura invasion were most, EGFR mutation was least frequent not only in pathological stage I but also stage II + IIIA. In multivariate analysis, age, pathological stage, vascular invasion, and group D were independent factors affected RFS and OS.

Conclusion: Limited to lobectomy cases, solid + micropapillary was independent prognostic factor both in early and locally advanced stage. Its malignant degree was related to the frequency of pathological invasive factors and EGFR mutation status.

Keywords: Adenocarcinoma; Adenocarcinoma predominance; Lobectomy; The Japanese lung cancer registry.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A. RFS curves according to pathological stage. The 5-year RFS rates was 88.5% in patients with stage IA, 72.0% in stage IB, 49.2% in stage IIA, 43.0% in stage IIB and 27.5% in stage IIIA. B. RFS curves according to histologic predominance. The 5-year RFS rates was 94.5% in patients with AIS, 91.7% in MIA, 84.5% in lepidic, 73.6% in variants, 69.0% in papillary, 65.3% in acinar, 51.6% in micropapillary, and 51.4% in solid. C RFS curves for each histological groups in pathological stage I. The 5-year RFS rate was 92.2% in patients with group A (AIS + MIA), 89.3% in group B (lepidic), 79.2% in group C (papillary + acinar + variants) and 69.0% in group D (solid + micropapillary). D RFS curves of each histological groups in pathological stage II + IIIA. The 5-year RFS rates was 43.6% in patients with group B, 39.5% in group C and 31.0% in group D
Fig. 2
Fig. 2
A. OS curves according to pathological stage. 5-year OS rates were 92.9% in patients with stage IA, 85.3% in stage IB, 70.9% in p stage IIA, 64.4% in stage IIB and 59.8% in stage IIIA. B. OS curves according to predominant histological subtype. The 5-year OS rates was 94.4% in patients with AIS. 94.0% in MIA, 90.2% in lepidic, 86.7% in variants, 84.1% in papillary, 80.4% in acinar, 78.0% in micropapillary and 65.4% in solid. C. OS curves according to histological groups in pathological stage I. The 5-year OS rates was 95.8% in patients with group A, 92.1% in group B, 89.7% in group C and 79.0% in group D. D. OS curves according to histological groups in pathological stage II + III. The 5-year OS rates was 72.4% in patients with group B, 66.9% in group C and 53.7% in group D
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References

    1. Sawabata N, Miyaoka E, Asamura H, Nakanishi Y, Eguchi K, Mori M, Nomori H, Fujii Y, Okumura M, Yokoi K, Japanese Joint Committee for Lung Cancer Registration Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol. 2011;6:1229–35. doi: 10.1097/JTO.0b013e318219aae2. - DOI - PubMed
    1. Okami J, Shintani Y, Okumura M, Ito H, Ohtsuka T, Toyooka S, Mori T, Watanabe S, Date H, Yokoi K, Asamura H, Nagayasu T, Miyaoka E, Yoshino I, on behalf of the Japanese Joint Committee of Lung Cancer Registry Demographics, safety and quality, and prognostic information in both the seventh and eighth editions of the TNM classification in 18,973 surgical cases of the Japanese Joint committee of Lung Cancer Registry database in 2010. J Thorac Oncol. 2019;14(2):212–222. doi: 10.1016/j.jtho.2018.10.002. - DOI - PubMed
    1. Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, et al. International association for the study of lung cancer/American thoracic society / European respiratory Society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6:244–285. doi: 10.1097/JTO.0b013e318206a221. - DOI - PMC - PubMed
    1. Yoshizawa A, Motoi N, Riely GJ, Sima CS, Gerald WL, Kris MG, et al. Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol. 2011;24:653–664. doi: 10.1038/modpathol.2010.232. - DOI - PubMed
    1. Xu CH, Wang W, Wei Y, Hu HD, Zou J, Yan J, Yu LK, Yang RS, Wang Y. Prognostic value of the new International association for the study of lung cancer/American Thoracic Society/European Respiratory Society classification in stage IB lung adenocarcinoma. Eur J Surg Oncol. 2015;41(10):1430–1436. doi: 10.1016/j.ejso.2015.06.004. - DOI - PubMed