Κατεύθυνση Καρκίνος Πνεύμονα: Σύγχρονη Κλινικοεργαστηριακή Προσέγγιση και Έρευνα
Library of the School of Health Sciences

2020-09-17

2020

Gaitanakis Stylianos

Περικλής Τόμος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Άννα Καρακατσάνη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κων/νος Ν. Συρίγος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Κλινική σημασία των ιστολογικών υπότυπων του αδενοκαρκινώματος πνεύμονα πρώιμου σταδίου

Greek

Clinical significance of adenocarcinoma subtype in early stage lung cancer

OBJECTIVES
The 2015 IASLC/ATS/ERS classification has prevailed as a more clinically
accurate one, since mixed adenocarcinoma is further divided into five invasive
subtypes. The objective of the present review is to identify whether in early
stage adenocarcinoma, subtypes correlate with patients’ future prognosis.
METHODS
We evaluated a retrospective series of resected stage I and II lung
adenocarcinomas (102 patients) that were treated with anatomic resection at
the Thoracic Surgery Department of Sotiria GHCD. The predominant
histological subtype was identified by a non-institutional pathologist.
Three overall prognostic groups were identified: low grade: adenocarcinoma
in situ, minimally invasive adenocarcinoma and lepidic predominant ;
intermediate grade: papillary predominant and acinar predominant and high
grade: solid predominant and micropapillary predominant.
Disease-free survival (DFS) and overall survival (OS) were estimated for the
participants.
RESULTS
Concerning OS, the patients with high grade subtype had significantly poorer
survival than the patients with low and intermediate grade adenocarcinoma
(p<0,001). With histological subtype being an independent prognostic factor
for worse survival. Of equal importance were the results for the DFS, where
patients of intermediate grade had less frequently recurrence than the
patients with high grade adenocarcinoma (p<0,001).
Moreover, multivariate analysis showed that male gender and no adjuvant
chemotherapy for the high grade group were significant poor prognostic
factors.
CONCLUSIONS
Predominantly micropapillary and solid tumors constitute aggressive subtypes
which are correlated with earlier and more frequent recurrences after
successful surgical treatment. The recent 2015 IASLC/ATS/ERS classification
may determine the personalized prospective therapeutic approach of the
different histologic subtypes of lung adenocarcinoma.
Considering the high probability for recurrence of micropapillary or solid
tumors even for stage I, adjuvant therapies should be considered for this
subgroup of patients. On the other hand, the low grade of malignancy group
could point towards sublobar resections in the future.

Health Sciences

Adenocarcinoma, Subtype, Lung cancer

No

0

Yes

52

86

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https://pergamos.lib.uoa.gr/uoa/dl/object/2921782