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High-grade tumor classified by new system is a prognostic predictor in resected lung adenocarcinoma

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Abstract

Objectives

A grading system for pulmonary adenocarcinoma has not been established; hence, the International Association for the Study of Lung Cancer (IASLC) pathology panel developed a new grading system for invasive adenocarcinoma. We aimed to evaluate the prognostic significance of the IASLC grading system for invasive pulmonary adenocarcinoma.

Methods

We conducted a retrospective analysis of 471 Japanese patients with resected lung adenocarcinoma. Tumors were classified in accordance with the IASLC grading system and 2015 World Health Organization classification. We analyzed recurrence-free probability (RFP) and overall survival (OS) using the log-rank test and compared the two grading systems using the Cox proportional hazards model.

Results

Grade 3 tumors of the IASLC system and high-grade tumors of the 2015 World Health Organization classification were present in 38% and 17% of patients, respectively. The 5-year RFP was lower in patients with IASLC Grade 3 tumors (45%) than in patients with IASLC Grade 1 and 2 tumors (91% and 83%, respectively). The 5-year RFP of patients with IASLC Grade 2 tumors (83%) was higher than of those with 2015 World Health Organization intermediate tumors (69%). On multivariate analysis for recurrence, IASLC Grade 3 was an independent prognostic factor of worse RFP. We showed similar results on analysis for the OS.

Conclusions

The prognostic significance of IASLC Grade 3 tumors on recurrence-free probability was confirmed through both univariate and multivariate analyses. Thus, the IASLC Grade 3 tumor is an independent factor of poor prognosis in patients with resected lung adenocarcinoma.

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Funding

This work was supported in part by JSPS KAKENHI (Grant number JP20K07392).

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Chihiro Yoshida, Hiroyasu Yokomise & Tetsuhiko Go

  2. Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Emi Ibuki & Reiji Haba

  3. Department of Pathology, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane, 693-8501, Japan

    Kyuichi Kadota

Authors
  1. Chihiro Yoshida
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  2. Hiroyasu Yokomise
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  3. Emi Ibuki
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  4. Tetsuhiko Go
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  5. Reiji Haba
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  6. Kyuichi Kadota
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Contributions

CY: data curation, formal analysis, investigation, visualization, and writing-original draft preparation. KK: conceptualization, funding acquisition, methodology, writing-reviewing and editing. EI: resources. TG: validation. RH: project administration. HY: supervision.

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Correspondence to Kyuichi Kadota.

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Yoshida, C., Yokomise, H., Ibuki, E. et al. High-grade tumor classified by new system is a prognostic predictor in resected lung adenocarcinoma. Gen Thorac Cardiovasc Surg 70, 455–462 (2022). https://doi.org/10.1007/s11748-021-01758-3

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  • DOI: https://doi.org/10.1007/s11748-021-01758-3

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