Mitosis trumps T stage and proposed international association for the study of lung cancer/American thoracic society/european respiratory society classification for prognostic value in resected stage 1 lung adenocarcinoma

Duhig, Edwina Elizabeth, Dettrick, Andrew, Godbolt, David Burleigh, Pauli, John, van Zwieten, Anthony, Hansen, Aaron Richard, Yang, Ian Anthony, Fong, Kwun Meng, Clarke, Belinda E. and Bowman, Rayleen V. (2015) Mitosis trumps T stage and proposed international association for the study of lung cancer/American thoracic society/european respiratory society classification for prognostic value in resected stage 1 lung adenocarcinoma. Journal of Thoracic Oncology, 10 4: 673-681. doi:10.1097/JTO.0000000000000446


Author Duhig, Edwina Elizabeth
Dettrick, Andrew
Godbolt, David Burleigh
Pauli, John
van Zwieten, Anthony
Hansen, Aaron Richard
Yang, Ian Anthony
Fong, Kwun Meng
Clarke, Belinda E.
Bowman, Rayleen V.
Title Mitosis trumps T stage and proposed international association for the study of lung cancer/American thoracic society/european respiratory society classification for prognostic value in resected stage 1 lung adenocarcinoma
Journal name Journal of Thoracic Oncology   Check publisher's open access policy
ISSN 1556-1380
1556-0864
Publication date 2015-04-30
Year available 2015
Sub-type Article (original research)
DOI 10.1097/JTO.0000000000000446
Open Access Status Not Open Access
Volume 10
Issue 4
Start page 673
End page 681
Total pages 9
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams & Wilkins
Collection year 2016
Language eng
Formatted abstract
Introduction: We investigated whether a group of pathologists could reproducibly apply the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification for lung adenocarcinoma to a cohort of stage 1 tumors and whether this architectural classification and/or other parameters could demonstrate survival advantage.

Methods: A total of 145 cases of 7th edition of tumor, node, metastasis stage 1 adenocarcinoma were retrospectively reviewed for predominant architectural pattern, including cribriform pattern, nuclear grade, mitotic index, and necrosis. The parameters were assessed for reproducibility and survival and using multivariate analysis, compared with stage, age, and sex.

Results: The majority of tumors had a mixed architecture with the acinar pattern being the most common predominant architecture. Micropapillary and cribriform architecture were the least frequent patterns. This study demonstrated that a group of five pathologists could reproducibly apply the IASLC/ATS/ERS classification. Although there were insufficient cribriform-predominant adenocarcinomas for assessment, when the percentage of all cribriform was combined with other architectures, it was associated with a worse prognosis. The majority of the parameters assessed demonstrated significance with univariate analysis but only mitotic index, as assessed by the highest count/10 high-power fields remained significant with multivariate analysis.

Conclusion: In this study of resected stage 1 primary lung adenocarcinoma, we found mitotic index to be the only independent prognostic marker. It was more closely associated with outcome than either pathologic T stage or IASLC/ATS/ERS architecture-based classification. Further validation of concordance and reproducibility in reporting mitotic index, as well as validation of prognostic significance, needs to be undertaken in independent data sets.
Keyword Adenocarcinoma
International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification
Cribriform
Mitotic index
Survival
Prognosis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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