The percentage of lepidic growth is an independent prognostic factor in invasive adenocarcinoma of the lung

Diagn Pathol. 2015 Jul 9:10:94. doi: 10.1186/s13000-015-0335-8.

Abstract

Background: The literature is inconclusive as to whether the percentage of the lepidic component of an invasive adenocarcinoma (AC) of the lung influences prognosis. We studied a population-based series of selected, resected invasive pulmonary ACs to determine if incremental increases in the lepidic component were an independent, prognostic variable.

Methods: Patients undergoing resection for lung cancer reported to the Cancer Registry of Norway and diagnosed in the period 1993-2002 with a bronchioloalveolar carcinoma (BAC) (old terminology) (adenocarcinoma in situ, AIS in the new terminology) in the lung were selected. A pulmonary pathologist reviewed all sections and estimated the percentage of the lepidic component. Follow-up of survival was to the end of 2013.

Results: One hundred thirty-one patients were identified, 102 had AC with lepidic growth. Of these, 44 had AC with a component of lepidic growth less than 50% and seven had AC with 95% lepidic component or more. One of the latter cases was considered to be AIS. In regression analyses, superior survival was associated with a greater lepidic component (p = 0.041). Mucinous tumors had a worse prognosis than non-mucinous (p = 0.012) in regression analyses, as did increasing age and stage. The five-year observed survival was 69.0% for non-mucinous cases and 66.7% for the group with a lepidic component of 80% or greater.

Conclusion: The percentage of the lepidic component appears to be an independent, significant prognostic factor in a selection of pulmonary AC.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Adenocarcinoma in Situ / mortality
  • Adenocarcinoma in Situ / pathology*
  • Adenocarcinoma in Situ / surgery
  • Adenocarcinoma of Lung
  • Adenocarcinoma, Bronchiolo-Alveolar / mortality
  • Adenocarcinoma, Bronchiolo-Alveolar / pathology*
  • Adenocarcinoma, Bronchiolo-Alveolar / surgery
  • Adenocarcinoma, Mucinous / mortality
  • Adenocarcinoma, Mucinous / pathology*
  • Adenocarcinoma, Mucinous / surgery
  • Aged
  • Cell Proliferation*
  • Female
  • Humans
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Norway
  • Pneumonectomy
  • Registries
  • Risk Factors
  • Survival Analysis
  • Time Factors
  • Treatment Outcome
  • Tumor Burden