Journal article

A Grading System for Invasive Pulmonary Adenocarcinoma: A Proposal From the International Association for the Study of Lung Cancer Pathology Committee.

  • Moreira AL Department of Pathology, New York University Langone Health, New York, New York. Electronic address: andre.moreira@nyumc.org.
  • Ocampo PSS Department of Pathology, New York University Langone Health, New York, New York.
  • Xia Y Department of Biostatistics, New York University Langone Health, New York, New York.
  • Zhong H Department of Biostatistics, New York University Langone Health, New York, New York.
  • Russell PA Department of Pathology, St. Vincent's Hospital, Victoria, Australia.
  • Minami Y Department of Pathology, Ibarakihigashi National Hospital, Tokai, Japan.
  • Cooper WA Department of Pathology, Royal Prince Alfred Hospital, Camperdown, Australia.
  • Yoshida A Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.
  • Bubendorf L Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Switzerland.
  • Papotti M Department of Oncology, University of Turin, Turin, Italy.
  • Pelosi G Department of Pathology, University of Milan, Milan Italy; IRCCS MultiMedica, Milan Italy.
  • Lopez-Rios F Pathology-Laboratorio de Dianas Terapeuticas, HM Hospitales, Madrid, Spain.
  • Kunitoki K Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  • Ferrari-Light D Department of Surgery, New York University Langone Health, New York, New York.
  • Sholl LM Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
  • Beasley MB Department of Pathology, Icahn School of Medicine, Mount Sinai Health System, New York, New York.
  • Borczuk A Department of Pathology, Weill Cornell Medicine, New York, New York.
  • Botling J Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University Hospital, Uppsala, Sweden.
  • Brambilla E Department of Anatomic Pathology and Cytology, Université Grenoble Alpes, Grenoble, France.
  • Chen G Department fo Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
  • Chou TY Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chung JH Department of Pathology, Seoul National University Bundang Hospital, Seoul, South Korea.
  • Dacic S Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
  • Jain D Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
  • Hirsch FR Center for Thoracic Oncology, The Tisch Cancer Institute, New York, New York.
  • Hwang D Department of Laboratory Medicine & Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
  • Lantuejoul S Department fo Pathology, Centre Léon Bérard Unicancer, Lyon, France.
  • Lin D Department of Pathology, Peking University Cancer Hospital and Institute, Beijing, People's Republic of China.
  • Longshore JW Carolinas Pathology Group, Atrium Health, Charlotte, North Carolina.
  • Motoi N Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.
  • Noguchi M Department of Pathology, University of Tsukuba, Tsukuba, Japan.
  • Poleri C Office of Pathology Consultants, Buenos Aires, Argentina.
  • Rekhtman N Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Tsao MS University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
  • Thunnissen E Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
  • Travis WD Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Yatabe Y Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.
  • Roden AC Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
  • Daigneault JB International Association for the Study of Lung Cancer, Aurora, Colorado.
  • Wistuba II Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  • Kerr KM Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
  • Pass H Department of Surgery, New York University Langone Health, New York, New York.
  • Nicholson AG Department of Pathology, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom.
  • Mino-Kenudson M Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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  • 2020-06-21
Published in:
  • Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. - 2020
English 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.
Language
  • English
Open access status
bronze
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Persistent URL
https://sonar.ch/global/documents/299403
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