Histological scoring for small lung adenocarcinomas 2 cm or less in diameter: A reliable prognostic indicator

Akiko Miyagi Maeshima, Naobumi Tochigi, Akihiko Yoshida, Hisao Asamura, Koji Tsuta, Hitoshi Tsuda

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: Lung adenocarcinomas 2 cm or less in diameter were studied to develop histologic criteria predicting the outcome. MATERIALS and Methods: We reviewed 510 consecutive lung adenocarcinomas 2 cm or less in diameter and assessed three histologic parameters to implement a histologic scoring system: lymphovascular invasion, maximum diameter of the nonbronchioloalveolar carcinoma (BAC) component, and percentage of the solid, cribriform, and/or papillary component in the entire tumor volume (%solid/cribriform/papillary). One point was given to each of lymphovascular invasion-positive, non-BAC >10 mm and %solid/cribriform/papillary 30%, and by the sum of these points, a score of 0 to 3 was assigned for each tumor. We also evaluated minimally invasive adenocarcinomas comprising non-BAC 5 mm, Sakurai grades 1 and 2. Results: Five-year disease-free survival rates of 287 patients with a histologic score of 0, 69 with a score of 1, 64 with a score of 2, and 90 with a score of 3 were 98.9%, 92.4%, 78.4%, and 54.0%, respectively. The 510 tumors included 129 noninvasive and 127 minimally invasive adenocarcinomas. None of these tumors recurred. In remaining 254 patients with overtly invasive adenocarcinomas, 5-year disease-free survival rates in 51 with a histologic score of 0, 49 with a score of 1, 64 with a score of 2, and 90 with a score of 3 were 95.9%, 89.2%, 79.4%, and 54.2%, respectively. Conclusion: The histologic scoring system comprising lymphovascular invasion-positive, non-BAC >10 mm and %solid/cribriform/papillary 30% is able to predict the outcome of lung adenocarcinomas 2 cm or less in diameter not only in all cases but also in overtly invasive adenocarcinomas. Minimally invasive adenocarcinomas did not recur in this large series.

Original languageEnglish
Pages (from-to)333-339
Number of pages7
JournalJournal of Thoracic Oncology
Volume5
Issue number3
DOIs
Publication statusPublished - 2010 Mar
Externally publishedYes

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Adenocarcinoma
Disease-Free Survival
Survival Rate
Neoplasms
Tumor Burden
Adenocarcinoma of lung
Carcinoma

Keywords

  • %solid/cribriform/ papillary
  • Lung
  • Non-BAC size
  • Scoring
  • Small adenocarcinoma
  • Vessel invasion

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Histological scoring for small lung adenocarcinomas 2 cm or less in diameter : A reliable prognostic indicator. / Maeshima, Akiko Miyagi; Tochigi, Naobumi; Yoshida, Akihiko; Asamura, Hisao; Tsuta, Koji; Tsuda, Hitoshi.

In: Journal of Thoracic Oncology, Vol. 5, No. 3, 03.2010, p. 333-339.

Research output: Contribution to journalArticle

Maeshima, Akiko Miyagi ; Tochigi, Naobumi ; Yoshida, Akihiko ; Asamura, Hisao ; Tsuta, Koji ; Tsuda, Hitoshi. / Histological scoring for small lung adenocarcinomas 2 cm or less in diameter : A reliable prognostic indicator. In: Journal of Thoracic Oncology. 2010 ; Vol. 5, No. 3. pp. 333-339.
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abstract = "Objective: Lung adenocarcinomas 2 cm or less in diameter were studied to develop histologic criteria predicting the outcome. MATERIALS and Methods: We reviewed 510 consecutive lung adenocarcinomas 2 cm or less in diameter and assessed three histologic parameters to implement a histologic scoring system: lymphovascular invasion, maximum diameter of the nonbronchioloalveolar carcinoma (BAC) component, and percentage of the solid, cribriform, and/or papillary component in the entire tumor volume ({\%}solid/cribriform/papillary). One point was given to each of lymphovascular invasion-positive, non-BAC >10 mm and {\%}solid/cribriform/papillary 30{\%}, and by the sum of these points, a score of 0 to 3 was assigned for each tumor. We also evaluated minimally invasive adenocarcinomas comprising non-BAC 5 mm, Sakurai grades 1 and 2. Results: Five-year disease-free survival rates of 287 patients with a histologic score of 0, 69 with a score of 1, 64 with a score of 2, and 90 with a score of 3 were 98.9{\%}, 92.4{\%}, 78.4{\%}, and 54.0{\%}, respectively. The 510 tumors included 129 noninvasive and 127 minimally invasive adenocarcinomas. None of these tumors recurred. In remaining 254 patients with overtly invasive adenocarcinomas, 5-year disease-free survival rates in 51 with a histologic score of 0, 49 with a score of 1, 64 with a score of 2, and 90 with a score of 3 were 95.9{\%}, 89.2{\%}, 79.4{\%}, and 54.2{\%}, respectively. Conclusion: The histologic scoring system comprising lymphovascular invasion-positive, non-BAC >10 mm and {\%}solid/cribriform/papillary 30{\%} is able to predict the outcome of lung adenocarcinomas 2 cm or less in diameter not only in all cases but also in overtly invasive adenocarcinomas. Minimally invasive adenocarcinomas did not recur in this large series.",
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T1 - Histological scoring for small lung adenocarcinomas 2 cm or less in diameter

T2 - A reliable prognostic indicator

AU - Maeshima, Akiko Miyagi

AU - Tochigi, Naobumi

AU - Yoshida, Akihiko

AU - Asamura, Hisao

AU - Tsuta, Koji

AU - Tsuda, Hitoshi

PY - 2010/3

Y1 - 2010/3

N2 - Objective: Lung adenocarcinomas 2 cm or less in diameter were studied to develop histologic criteria predicting the outcome. MATERIALS and Methods: We reviewed 510 consecutive lung adenocarcinomas 2 cm or less in diameter and assessed three histologic parameters to implement a histologic scoring system: lymphovascular invasion, maximum diameter of the nonbronchioloalveolar carcinoma (BAC) component, and percentage of the solid, cribriform, and/or papillary component in the entire tumor volume (%solid/cribriform/papillary). One point was given to each of lymphovascular invasion-positive, non-BAC >10 mm and %solid/cribriform/papillary 30%, and by the sum of these points, a score of 0 to 3 was assigned for each tumor. We also evaluated minimally invasive adenocarcinomas comprising non-BAC 5 mm, Sakurai grades 1 and 2. Results: Five-year disease-free survival rates of 287 patients with a histologic score of 0, 69 with a score of 1, 64 with a score of 2, and 90 with a score of 3 were 98.9%, 92.4%, 78.4%, and 54.0%, respectively. The 510 tumors included 129 noninvasive and 127 minimally invasive adenocarcinomas. None of these tumors recurred. In remaining 254 patients with overtly invasive adenocarcinomas, 5-year disease-free survival rates in 51 with a histologic score of 0, 49 with a score of 1, 64 with a score of 2, and 90 with a score of 3 were 95.9%, 89.2%, 79.4%, and 54.2%, respectively. Conclusion: The histologic scoring system comprising lymphovascular invasion-positive, non-BAC >10 mm and %solid/cribriform/papillary 30% is able to predict the outcome of lung adenocarcinomas 2 cm or less in diameter not only in all cases but also in overtly invasive adenocarcinomas. Minimally invasive adenocarcinomas did not recur in this large series.

AB - Objective: Lung adenocarcinomas 2 cm or less in diameter were studied to develop histologic criteria predicting the outcome. MATERIALS and Methods: We reviewed 510 consecutive lung adenocarcinomas 2 cm or less in diameter and assessed three histologic parameters to implement a histologic scoring system: lymphovascular invasion, maximum diameter of the nonbronchioloalveolar carcinoma (BAC) component, and percentage of the solid, cribriform, and/or papillary component in the entire tumor volume (%solid/cribriform/papillary). One point was given to each of lymphovascular invasion-positive, non-BAC >10 mm and %solid/cribriform/papillary 30%, and by the sum of these points, a score of 0 to 3 was assigned for each tumor. We also evaluated minimally invasive adenocarcinomas comprising non-BAC 5 mm, Sakurai grades 1 and 2. Results: Five-year disease-free survival rates of 287 patients with a histologic score of 0, 69 with a score of 1, 64 with a score of 2, and 90 with a score of 3 were 98.9%, 92.4%, 78.4%, and 54.0%, respectively. The 510 tumors included 129 noninvasive and 127 minimally invasive adenocarcinomas. None of these tumors recurred. In remaining 254 patients with overtly invasive adenocarcinomas, 5-year disease-free survival rates in 51 with a histologic score of 0, 49 with a score of 1, 64 with a score of 2, and 90 with a score of 3 were 95.9%, 89.2%, 79.4%, and 54.2%, respectively. Conclusion: The histologic scoring system comprising lymphovascular invasion-positive, non-BAC >10 mm and %solid/cribriform/papillary 30% is able to predict the outcome of lung adenocarcinomas 2 cm or less in diameter not only in all cases but also in overtly invasive adenocarcinomas. Minimally invasive adenocarcinomas did not recur in this large series.

KW - %solid/cribriform/ papillary

KW - Lung

KW - Non-BAC size

KW - Scoring

KW - Small adenocarcinoma

KW - Vessel invasion

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