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J Surg Oncol. 2013 Apr;107(5):474-80. doi: 10.1002/jso.23259. Epub 2012 Sep 5.

Prognostic significance of the IASLC/ATS/ERS classification in Chinese patients-A single institution retrospective study of 292 lung adenocarcinoma.

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Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.



A new classification of pulmonary adenocarcinoma has been recently proposed by the International Association for the Study of Lung Cancer, American Thoracic Society and European Respiratory Society (IASLC/ATS/ERS). This study was undertaken in an attempt to explore the clinical implication of this new classification in Chinese patients.


Two hundred ninety-two lung adenocarcinomas were reclassified strictly according to the IASLC/ATS/ERS classification by two pathologists, independently. Kaplan-Meier and Cox regression analyses were used to analyze the correlation between the new classification and patients' prognosis.


We confirmed three groups with different outcomes. Both AIS and MIA had 100% 5-year disease-free survival rate and 100% 5-year overall survival rate. Lepidic, acinar, and papillary as well as variants of invasive adenocarcinoma had intermediate prognosis. Solid and micropapillary cases had poor prognosis (DFS: P < 0.001, OS: P = 0.002). After controlling the clinicopathological factors, the new classification was identified as an independent prognostic factor in patients' disease-free survival and overall survival.


We have demonstrated a valuable prognostic role of the new classification in Chinese patients. This new classification is valuable of screening out patients with high risk of recurrence to receive postoperative adjuvant therapy.

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