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Multicenter Study
. 2022 Oct;200(5):649-660.
doi: 10.1007/s00408-022-00561-y. Epub 2022 Aug 21.

Impact of High-Grade Patterns in Early-Stage Lung Adenocarcinoma: A Multicentric Analysis

Pietro Bertoglio #  1 , Vittorio Aprile #  2 , Luigi Ventura  3   4 , Maria Cattoni  5 , Dania Nachira  6 , Filippo Lococo  6 , Maria Rodriguez Perez  7 , Francesco Guerrera  8 , Fabrizio Minervini  9 , Giulia Querzoli  10 , Giovanni Bocchialini  3 , Diana Bacchin  11 , Francesca Franzi  12 , Guido Rindi  13 , Salvatore Bellafiore  14 , Federico Femia  8 , Giuseppe Salvatore Bogina  10 , Piergiorgio Solli  1 , Peter Kestenholz  9 , Enrico Ruffini  8 , Massimiliano Paci  15 , Stefano Margaritora  6 , Andrea Selenito Imperatori  5 , Marco Lucchi  11 , Letizia Gnetti  16 , Alberto Claudio Terzi  17
Affiliations
Multicenter Study

Impact of High-Grade Patterns in Early-Stage Lung Adenocarcinoma: A Multicentric Analysis

Pietro Bertoglio et al. Lung. 2022 Oct.

Abstract

Objective: The presence of micropapillary and solid adenocarcinoma patterns leads to a worse survival and a significantly higher tendency to recur. This study aims to assess the impact of pT descriptor combined with the presence of high-grade components on long-term outcomes in early-stage lung adenocarcinomas.

Methods: We retrospectively collected data of consecutive resected pT1-T3N0 lung adenocarcinoma from nine European Thoracic Centers. All patients who underwent a radical resection with lymph-node dissection between 2014 and 2017 were included. Differences in Overall Survival (OS) and Disease-Free Survival (DFS) and possible prognostic factors associated with outcomes were evaluated also after performing a propensity score matching to compare tumors containing non-high-grade and high-grade patterns.

Results: Among 607 patients, the majority were male and received a lobectomy. At least one high-grade histological pattern was seen in 230 cases (37.9%), of which 169 solid and 75 micropapillary. T1a-b-c without high-grade pattern had a significant better prognosis compared to T1a-b-c with high-grade pattern (p = 0.020), but the latter had similar OS compared to T2a (p = 0.277). Concurrently, T1a-b-c without micropapillary or solid patterns had a significantly better DFS compared to those with high-grade patterns (p = 0.034), and it was similar to T2a (p = 0.839). Multivariable analysis confirms the role of T descriptor according to high-grade pattern both for OS (p = 0.024; HR 1.285 95% CI 1.033-1.599) and DFS (p = 0.003; HR 1.196, 95% CI 1.054-1.344, respectively). These results were confirmed after the propensity score matching analysis.

Conclusions: pT1 lung adenocarcinomas with a high-grade component have similar prognosis of pT2a tumors.

Keywords: Adenocarcinoma subtypes; Lung adenocarcinoma; Lung cancer; TNM staging.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
a Overall Survival of T1a-b-c non-high-grade and T1a-b-c high-grade in the whole cohort. Confidence interval: 95%; b Disease-Free Survival of T1a-b-c non-high-grade and T1a-b-c high-grade in the whole cohort. CI 95%
Fig. 2
Fig. 2
a Overall Survival of T2a non-high-grade and T1a-b-c high-grade in the whole cohort; b Disease-Free Survival of T2a non-high-grade and T1a-b-c high-grade in the whole cohort. CI 95%
Fig. 3
Fig. 3
a Overall Survival of T2a-b non-high-grade and T2a-b high-grade in the whole cohort; b Disease-Free Survival of T2a-b non-high-grade and T2a-b high-grade in the whole cohort. CI 95%
Fig. 4
Fig. 4
a Overall Survival of T3 non-high-grade and T3 high-grade in the whole cohort; b Disease-Free Survival of T3 non-high-grade and T3 high-grade in the whole cohort. CI 95%
Fig. 5
Fig. 5
a Overall Survival of T1a-b-c non-high-grade and T1a-b-c high-grade in the matched cohort; b Disease-Free Survival of T1a-b-c non-high-grade and T1a-b-c high-grade in the matched cohort. CI 95%
See this image and copyright information in PMC

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