Micropapillary and solid subtypes of invasive lung adenocarcinoma: Clinical predictors of histopathology and outcome
Objective To evaluate the clinical effect of the presence of a micropapillary or solid subtype on the outcomes in lung adenocarcinoma and to determine the predictors of such a histopathologic diagnosis. Methods A total of 511 patients with lung adenocarcinoma ≤3 cm were included. According to the pr...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2014-03, Vol.147 (3), p.921-928.e2 |
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| creator | Cha, Min Jae, MD Lee, Ho Yun, MD Lee, Kyung Soo, MD Jeong, Ji Yun, MD Han, Joungho, MD Shim, Young Mog, MD Hwang, Hye Sun, MD |
| description | Objective To evaluate the clinical effect of the presence of a micropapillary or solid subtype on the outcomes in lung adenocarcinoma and to determine the predictors of such a histopathologic diagnosis. Methods A total of 511 patients with lung adenocarcinoma ≤3 cm were included. According to the presence of micropapillary or solid subtypes, we classified the patients into 4 subgroups: both subtypes absent (MP−/S−, n = 87), either subtype present (MP+/S−, n = 207 and MP−/S+, n = 196), and both present (MP+/S+, n = 21) to determine the association between the micropapillary or solid subtype and survival outcome or clinical and imaging conditions. Univariate and multivariate analyses were undertaken to determine the parameters, allowing the prediction of the presence of the micropapillary or solid subtype. Results Overall survival (OS) and disease-free survival (DFS) differed significantly among the 4 subgroups ( P |
| doi_str_mv | 10.1016/j.jtcvs.2013.09.045 |
| format | Article |
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Methods A total of 511 patients with lung adenocarcinoma ≤3 cm were included. According to the presence of micropapillary or solid subtypes, we classified the patients into 4 subgroups: both subtypes absent (MP−/S−, n = 87), either subtype present (MP+/S−, n = 207 and MP−/S+, n = 196), and both present (MP+/S+, n = 21) to determine the association between the micropapillary or solid subtype and survival outcome or clinical and imaging conditions. Univariate and multivariate analyses were undertaken to determine the parameters, allowing the prediction of the presence of the micropapillary or solid subtype. Results Overall survival (OS) and disease-free survival (DFS) differed significantly among the 4 subgroups ( P < .001 and P = .004, respectively). The MP−/S− tumors showed better DFS than those containing either the micropapillary or solid subtype. Patients with the micropapillary subtype had significantly worse OS than patients without the micropapillary subtype. This difference remained significant, together with stage, after adjustment for gender, age, adjuvant therapy, tumor size, and solid subtype (DFS and OS, P = .016 and P = .002, respectively). On multivariate analysis, greater than stage I, tumor size ≥2.5 cm, solid mass, and maximal standardized uptake value of ≥7 were independent predictors of the presence of a micropapillary or solid subtype. Conclusions Micropapillary and solid subtypes are common in tumors greater than stage I, with size ≥2.5 cm, pure solid type, and maximal standardized uptake value of ≥7, which were predictors for poor DFS. The presence of the micropapillary subtype was a single prognostic factor for OS.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2013.09.045</identifier><identifier>PMID: 24199757</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - therapy ; Adenocarcinoma of Lung ; Adenocarcinoma, Papillary - mortality ; Adenocarcinoma, Papillary - pathology ; Adenocarcinoma, Papillary - therapy ; Adult ; Aged ; Aged, 80 and over ; Cardiothoracic Surgery ; Disease Progression ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Time Factors ; Tumor Burden</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2014-03, Vol.147 (3), p.921-928.e2</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2014 The American Association for Thoracic Surgery</rights><rights>Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-7683a794c31db0fd1f415fc9bb8389f13df3708d3278365f4a54662eaff3dffa3</citedby><cites>FETCH-LOGICAL-c525t-7683a794c31db0fd1f415fc9bb8389f13df3708d3278365f4a54662eaff3dffa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522313011422$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24199757$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cha, Min Jae, MD</creatorcontrib><creatorcontrib>Lee, Ho Yun, MD</creatorcontrib><creatorcontrib>Lee, Kyung Soo, MD</creatorcontrib><creatorcontrib>Jeong, Ji Yun, MD</creatorcontrib><creatorcontrib>Han, Joungho, MD</creatorcontrib><creatorcontrib>Shim, Young Mog, MD</creatorcontrib><creatorcontrib>Hwang, Hye Sun, MD</creatorcontrib><title>Micropapillary and solid subtypes of invasive lung adenocarcinoma: Clinical predictors of histopathology and outcome</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective To evaluate the clinical effect of the presence of a micropapillary or solid subtype on the outcomes in lung adenocarcinoma and to determine the predictors of such a histopathologic diagnosis. Methods A total of 511 patients with lung adenocarcinoma ≤3 cm were included. According to the presence of micropapillary or solid subtypes, we classified the patients into 4 subgroups: both subtypes absent (MP−/S−, n = 87), either subtype present (MP+/S−, n = 207 and MP−/S+, n = 196), and both present (MP+/S+, n = 21) to determine the association between the micropapillary or solid subtype and survival outcome or clinical and imaging conditions. Univariate and multivariate analyses were undertaken to determine the parameters, allowing the prediction of the presence of the micropapillary or solid subtype. Results Overall survival (OS) and disease-free survival (DFS) differed significantly among the 4 subgroups ( P < .001 and P = .004, respectively). The MP−/S− tumors showed better DFS than those containing either the micropapillary or solid subtype. Patients with the micropapillary subtype had significantly worse OS than patients without the micropapillary subtype. This difference remained significant, together with stage, after adjustment for gender, age, adjuvant therapy, tumor size, and solid subtype (DFS and OS, P = .016 and P = .002, respectively). On multivariate analysis, greater than stage I, tumor size ≥2.5 cm, solid mass, and maximal standardized uptake value of ≥7 were independent predictors of the presence of a micropapillary or solid subtype. Conclusions Micropapillary and solid subtypes are common in tumors greater than stage I, with size ≥2.5 cm, pure solid type, and maximal standardized uptake value of ≥7, which were predictors for poor DFS. The presence of the micropapillary subtype was a single prognostic factor for OS.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - therapy</subject><subject>Adenocarcinoma of Lung</subject><subject>Adenocarcinoma, Papillary - mortality</subject><subject>Adenocarcinoma, Papillary - pathology</subject><subject>Adenocarcinoma, Papillary - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiothoracic Surgery</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Tumor Burden</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1r3DAQhkVpaLZpf0Gh-NiLHY1k2VahhbD0I5DQQ1voTcj6SOTalivJC_vvq81ue8glF41g3vcd5hmE3gCuAENzOVRDUrtYEQy0wrzCNXuGNoB5WzYd-_UcbTAmpGSE0HP0MsYBY9xi4C_QOamB85a1G5RunQp-kYsbRxn2hZx1Ef3o8rv2ab-YWHhbuHkno9uZYlznu0JqM3slg3Kzn-T7Yju62Sk5Fksw2qnkw4Pp3sWUk9O9H_3dMdmvSfnJvEJnVo7RvD7VC_Tz86cf26_lzbcv19urm1IxwlLZNh2VLa8VBd1jq8HWwKzifd_Rjlug2tIWd5qStqMNs7VkddMQI63NLSvpBXp3zF2C_7OamMTkojJ509n4NQqoOQcGjEGW0qM004gxGCuW4KZMRAAWB9xiEA-4xQG3wFxk3Nn19jRg7Sej_3v-8c2CD0eByWvunAkiKmdmlTkFo5LQ3j0x4OMjvzrB_m32Jg5-DXMmKEBEIrD4frj44eBAMUCdP38BZ3Wp4Q</recordid><startdate>20140301</startdate><enddate>20140301</enddate><creator>Cha, Min Jae, MD</creator><creator>Lee, Ho Yun, MD</creator><creator>Lee, Kyung Soo, MD</creator><creator>Jeong, Ji Yun, MD</creator><creator>Han, Joungho, MD</creator><creator>Shim, Young Mog, MD</creator><creator>Hwang, Hye Sun, MD</creator><general>Mosby, Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140301</creationdate><title>Micropapillary and solid subtypes of invasive lung adenocarcinoma: Clinical predictors of histopathology and outcome</title><author>Cha, Min Jae, MD ; Lee, Ho Yun, MD ; Lee, Kyung Soo, MD ; Jeong, Ji Yun, MD ; Han, Joungho, MD ; Shim, Young Mog, MD ; Hwang, Hye Sun, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-7683a794c31db0fd1f415fc9bb8389f13df3708d3278365f4a54662eaff3dffa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - therapy</topic><topic>Adenocarcinoma of Lung</topic><topic>Adenocarcinoma, Papillary - mortality</topic><topic>Adenocarcinoma, Papillary - pathology</topic><topic>Adenocarcinoma, Papillary - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiothoracic Surgery</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Tumor Burden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cha, Min Jae, MD</creatorcontrib><creatorcontrib>Lee, Ho Yun, MD</creatorcontrib><creatorcontrib>Lee, Kyung Soo, MD</creatorcontrib><creatorcontrib>Jeong, Ji Yun, MD</creatorcontrib><creatorcontrib>Han, Joungho, MD</creatorcontrib><creatorcontrib>Shim, Young Mog, MD</creatorcontrib><creatorcontrib>Hwang, Hye Sun, MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cha, Min Jae, MD</au><au>Lee, Ho Yun, MD</au><au>Lee, Kyung Soo, MD</au><au>Jeong, Ji Yun, MD</au><au>Han, Joungho, MD</au><au>Shim, Young Mog, MD</au><au>Hwang, Hye Sun, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Micropapillary and solid subtypes of invasive lung adenocarcinoma: Clinical predictors of histopathology and outcome</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2014-03-01</date><risdate>2014</risdate><volume>147</volume><issue>3</issue><spage>921</spage><epage>928.e2</epage><pages>921-928.e2</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Objective To evaluate the clinical effect of the presence of a micropapillary or solid subtype on the outcomes in lung adenocarcinoma and to determine the predictors of such a histopathologic diagnosis. Methods A total of 511 patients with lung adenocarcinoma ≤3 cm were included. According to the presence of micropapillary or solid subtypes, we classified the patients into 4 subgroups: both subtypes absent (MP−/S−, n = 87), either subtype present (MP+/S−, n = 207 and MP−/S+, n = 196), and both present (MP+/S+, n = 21) to determine the association between the micropapillary or solid subtype and survival outcome or clinical and imaging conditions. Univariate and multivariate analyses were undertaken to determine the parameters, allowing the prediction of the presence of the micropapillary or solid subtype. Results Overall survival (OS) and disease-free survival (DFS) differed significantly among the 4 subgroups ( P < .001 and P = .004, respectively). The MP−/S− tumors showed better DFS than those containing either the micropapillary or solid subtype. Patients with the micropapillary subtype had significantly worse OS than patients without the micropapillary subtype. This difference remained significant, together with stage, after adjustment for gender, age, adjuvant therapy, tumor size, and solid subtype (DFS and OS, P = .016 and P = .002, respectively). On multivariate analysis, greater than stage I, tumor size ≥2.5 cm, solid mass, and maximal standardized uptake value of ≥7 were independent predictors of the presence of a micropapillary or solid subtype. Conclusions Micropapillary and solid subtypes are common in tumors greater than stage I, with size ≥2.5 cm, pure solid type, and maximal standardized uptake value of ≥7, which were predictors for poor DFS. The presence of the micropapillary subtype was a single prognostic factor for OS.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>24199757</pmid><doi>10.1016/j.jtcvs.2013.09.045</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - therapy Adenocarcinoma of Lung Adenocarcinoma, Papillary - mortality Adenocarcinoma, Papillary - pathology Adenocarcinoma, Papillary - therapy Adult Aged Aged, 80 and over Cardiothoracic Surgery Disease Progression Disease-Free Survival Female Humans Kaplan-Meier Estimate Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - therapy Male Middle Aged Multivariate Analysis Neoplasm Invasiveness Neoplasm Staging Prognosis Proportional Hazards Models Retrospective Studies Risk Factors Time Factors Tumor Burden |
| title | Micropapillary and solid subtypes of invasive lung adenocarcinoma: Clinical predictors of histopathology and outcome |
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