Work

Histologic subtyping in pathologic stage I-IIA lung adenocarcinoma provides risk-based stratification for surveillance

Year: 2018

Type: article

Abstract: // Yusuke Takahashi 1, 2 , Takashi Eguchi 1, 3 , Koji Kameda 1, 4 , Shaohua Lu 5, 6 , Raj G. Vaghjiani 1 , Kay See Tan 7 , William D. Travis 5 , David R. Jones 1 and Prasad S. Adusumilli 1, 8 1 Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA 2 Department of General Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan 3 Division of Thoracic Surgery, Department of Surgery, Shinshu University, Matsumoto, Japan 4 Department of Thoracic Surgery, National Defense Medical College, Tokorozawa, Japan 5 Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA 6 Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China 7 Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA 8 Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, NY, USA Correspondence to: Prasad S. Adusumilli, email: [email protected] Keywords: recurrence hazard; dynamics; solid; micropapillary; prognosis Received: August 07, 2018 Accepted: October 21, 2018 Published: November 06, 2018 ABSTRACT Background: We hypothesize that recurrence hazard following resection for stage I-IIA lung adenocarcinoma (ADC) varies according to histologic subtype, which may provide risk stratification for surveillance better than the current uniform follow-up protocol. Results: Presence (≥5%) of high-grade histologic subtypes (MIP and/or SOL) was associated with a significantly higher recurrence hazard: (1) presence of either MIP or SOL was associated with a significant increase in recurrence hazard during the first two years after surgery; (2) presence of SOL was associated with an increase in recurrence hazard—in particular, distant recurrence hazard—during the first year after surgery; (3) absence of high-grade subtypes (515/1,572 patients) was associated with a very low recurrence hazard (<2% risk/year) during the first ten years after surgery. Methods: All hematoxylin and eosin–stained tumor slides from pathologic stage I-IIA lung ADC ( n = 1572) were reviewed for quantification of the percentage of each histological subtype. Recurrence hazard was estimated using the Kernel-Epanechnikov smoothing procedure. The association between recurrence hazard and high-grade histologic subtypes (micropapillary [MIP] and solid [SOL]) was assessed. Conclusions: Our findings suggest that histologic subtyping has utility for identifying recurrence hazard for surgically resected stage I-IIA lung ADC patients and provide rationale for establishing risk-based surveillance.

Source: Oncotarget

DOI: 10.18632/oncotarget.26285