TY - JOUR
T1 - Prognostic impact of lung adenocarcinoma second predominant pattern from a large European database
AU - Bertoglio, Pietro
AU - Querzoli, Giulia
AU - Ventura, Luigi
AU - Aprile, Vittorio
AU - Cattoni, Maria A.
AU - Nachira, Dania
AU - Lococo, Filippo
AU - Rodriguez Perez, Maria
AU - Guerrera, Francesco
AU - Minervini, Fabrizio
AU - Gnetti, Letizia
AU - Bacchin, Diana
AU - Franzi, Francesca
AU - Rindi, Guido
AU - Bellafiore, Salvatore
AU - Femia, Federico
AU - Viti, Andrea
AU - Bogina, Giuseppe S.
AU - Kestenholz, Peter
AU - Ruffini, Enrico
AU - Paci, Massimiliano
AU - Margaritora, Stefano
AU - Imperatori, Andrea S.
AU - Lucchi, Marco
AU - Ampollini, Luca
AU - Terzi, Alberto C.
N1 - Publisher Copyright:
© 2020 Wiley Periodicals LLC
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background and Objectives: Adenocarcinoma patterns could be grouped based on clinical behaviors: low- (lepidic), intermediate- (papillary or acinar), and high-grade (micropapillary and solid). We analyzed the impact of the second predominant pattern (SPP) on disease-free survival (DFS). Methods: We retrospectively collected data of surgically resected stage I and II adenocarcinoma. Selection criteria: anatomical resection with lymphadenectomy and pathological N0. Pure adenocarcinomas and mucinous subtypes were excluded. Recurrence rate and factors affecting DFS were analyzed according to the SPP focusing on intermediate-grade predominant pattern adenocarcinomas. Results: Among 270 patients, 55% were male. The mean age was 68.3 years. SPP pattern appeared as follows: lepidic 43.0%, papillary 23.0%, solid 14.4%, acinar 11.9%, and micropapillary 7.8%. The recurrence rate was 21.5% and 5-year DFS was 71.1%. No difference in DFS was found according to SPP (p =.522). In patients with high-grade SPP, the percentage of SPP, age, and tumor size significantly influenced DFS (p =.016). In patients with lepidic SPP, size, male gender, and lymph-node sampling (p =.005; p =.014; p =.038, respectively) significantly influenced DFS. Conclusions: The impact of SPP on DFS is not homogeneous in a subset of patients with the intermediate-grade predominant patterns. The influence of high-grade SPP on DFS is related to its proportion in the tumor.
AB - Background and Objectives: Adenocarcinoma patterns could be grouped based on clinical behaviors: low- (lepidic), intermediate- (papillary or acinar), and high-grade (micropapillary and solid). We analyzed the impact of the second predominant pattern (SPP) on disease-free survival (DFS). Methods: We retrospectively collected data of surgically resected stage I and II adenocarcinoma. Selection criteria: anatomical resection with lymphadenectomy and pathological N0. Pure adenocarcinomas and mucinous subtypes were excluded. Recurrence rate and factors affecting DFS were analyzed according to the SPP focusing on intermediate-grade predominant pattern adenocarcinomas. Results: Among 270 patients, 55% were male. The mean age was 68.3 years. SPP pattern appeared as follows: lepidic 43.0%, papillary 23.0%, solid 14.4%, acinar 11.9%, and micropapillary 7.8%. The recurrence rate was 21.5% and 5-year DFS was 71.1%. No difference in DFS was found according to SPP (p =.522). In patients with high-grade SPP, the percentage of SPP, age, and tumor size significantly influenced DFS (p =.016). In patients with lepidic SPP, size, male gender, and lymph-node sampling (p =.005; p =.014; p =.038, respectively) significantly influenced DFS. Conclusions: The impact of SPP on DFS is not homogeneous in a subset of patients with the intermediate-grade predominant patterns. The influence of high-grade SPP on DFS is related to its proportion in the tumor.
KW - lung adenocarcinoma
KW - lung cancer biology
KW - lung cancer surgery
KW - non-small-cell lung cancer
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U2 - 10.1002/jso.26292
DO - 10.1002/jso.26292
M3 - Article
C2 - 33169397
AN - SCOPUS:85096685973
VL - 123
SP - 560
EP - 569
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
SN - 0022-4790
IS - 2
ER -