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. 2022 Dec;13(23):3310-3321.
doi: 10.1111/1759-7714.14687. Epub 2022 Nov 7.

Prognosis of resected invasive mucinous adenocarcinoma compared with the IASLC histologic grading system for invasive nonmucinous adenocarcinoma: Surgical database study in the TKIs era in Korea

Wongi Woo  1 , Young Ho Yang  2 , Yoon Jin Cha  3 , Duk Hwan Moon  1 , Hyo Sup Shim  4 , Arthur Cho  5 , Bong Jun Kim  6 , Ha Eun Kim  2 , Byung Jo Park  2 , Jin Gu Lee  2 , Dae Joon Kim  2 , Hyo Chae Paik  2 , Sungsoo Lee  1 , Chang Young Lee  2
Affiliations

Prognosis of resected invasive mucinous adenocarcinoma compared with the IASLC histologic grading system for invasive nonmucinous adenocarcinoma: Surgical database study in the TKIs era in Korea

Wongi Woo et al. Thorac Cancer. 2022 Dec.

Abstract

Background: The prognosis of invasive mucinous adenocarcinoma (IMA) remains controversial and should be clarified by comparison with the International Association for the Study of Lung Cancer (IASLC) histologic grading system for invasive nonmucinous adenocarcinoma (INMA).

Methods: This study included patients with IMA who underwent curative resection. Their clinicopathological outcomes were compared with those of patients with INMA. Propensity score matching was performed to compare the prognosis of IMA with IASLC grade 2 or 3. Kaplan-Meier survival curves and log-rank tests were used to analyze recurrence-free survival (RFS) and overall survival (OS).

Results: The prognoses of IMA and IASLC grade 2 were similar in terms of RFS and OS. Although patients with IMA had better RFS than patients with IASLC grade 3, the OS was not significantly different. After propensity score matching, IMA demonstrated similar RFS to IASLC grade 2 but superior to IASLC grade 3; there was no difference in the OS compared with grades 2/3. Multivariate analysis revealed that tumor size (hazard ratio [HR] = 1.20, p = 0.028), lymphovascular invasion (HR = 127.5, p = 0.003), and maximum standardized uptake value (HR = 1.24, p = 0.005) were poor prognostic predictors for RFS. Patients with IMA demonstrated RFS similar to and significantly better than that of patients with IASLC grades 2 and 3, respectively. For OS, IMA prognosis was between that of IASLC grades 2 and 3.

Conclusions: Since the prognosis of IMA among lung adenocarcinomas appears to be relatively worse, further clinical studies investigating IMA-specific treatment and follow-up plans are necessary to draw more inferences.

Keywords: classification; lung adenocarcinoma; mucinous adenocarcinoma; pathologic subtype; prognosis.

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Conflict of interest statement

The authors disclose no financial or nonfinancial conflicts of interest, including funding, provision of study materials, medical writing, or article processing charges. This research did not receive grants from funding agencies in the public, commercial, or not‐for‐profit sectors.

Figures

FIGURE 1
FIGURE 1
Recurrence‐free (a) and overall (b) survival curves of patients with IMA and INMA (IASLC grades 1–3). IALSC, International Association for the Study of Lung Cancer; INMA, invasive non‐mucinous adenocarcinoma; IMA, invasive mucinous adenocarcinoma
FIGURE 2
FIGURE 2
Recurrence‐free and overall survival curves between patients with IMA and IASLC grades 2 (a–b) and 3 (c–d) after propensity score matching. IALSC, International Association for the Study of Lung Cancer; IMA, invasive mucinous adenocarcinoma
See this image and copyright information in PMC

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