Prognostic value of the IASLC/ATS/ERS classification in stage I lung adenocarcinoma patients--based on a hospital study in China

Eur J Surg Oncol. 2013 Nov;39(11):1262-8. doi: 10.1016/j.ejso.2013.08.026. Epub 2013 Sep 11.


Aims: We investigated the relationship between predominant subtype, according to the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Lung Adenocarcinoma Classification, and prognosis in stage I lung adenocarcinoma in Zhejiang Cancer Hospital.

Methods: Two hundred and sixty-one patients with stage I lung adenocarcinoma, operated in Zhejiang Cancer Hospital, were identified between 2000 and 2010. Survival curves were plotted using the Kaplan-Meier method. The Cox proportional hazard model was used for multivariate analysis.

Results: None of the cases were adenocarcinoma in situ and six were minimally invasive adenocarcinomas. Two hundred and fifty-five cases were invasive adenocarcinoma. Of those, 80, 76, 42, 34, 19, and 4 were papillary predominant, acinar predominant, micropapillary predominant, solid predominant, lepidic predominant subtypes, and variants of invasive adenocarcinoma, respectively. Patients with micropapillary and solid predominant tumors had a significantly worse disease-free survival as compared to those with other subtypes predominant tumors (p < 0.001). Multivariate analysis revealed that the new classification was an independent predictor of the disease-free and overall survival (p = 0.002 and 0.015).

Conclusion: The predominant subtype in the primary tumor was associated with prognosis in resected stage I lung adenocarcinoma.

Keywords: IASLC/ATS/ERS classification; Non-small cell lung cancer; Prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / classification*
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Cancer Care Facilities / statistics & numerical data
  • China / epidemiology
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / classification*
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Societies, Medical