The new histological classification of lung primary adenocarcinoma subtypes is a reliable prognostic marker and identifies tumors with different mutation status: the experience of a French cohort.
Mansuet-Lupo A, Bobbio A, Blons H, Becht E, Ouakrim H, Didelot A, Charpentier MC, Bain S, Marmey B, Bonjour P, Biton J, Cremer I, Dieu-Nosjean MC, Sautès-Fridman C, Régnard JF, Laurent-Puig P, Alifano M, Damotte D. Chest. 2014 Mar
ABSTRACT BACKGROUND: Histological classification of lung adenocarcinoma subtype has a prognostic value in most studies. However, lung adenocarcinoma characteristics differ across countries. Here, we aimed at validating the prognostic value of this classification in a large French series of lung adenocarcinoma.
METHODS: We reviewed 407 consecutive lung adenocarcinomas operated on between 2001 and 2005 and reclassified them according to the IASLC/ATS/ERS classification and subsequently graded into low, intermediate and high grade. We analysed the relevance of this classification according to clinical, pathological, and molecular analysis.
RESULTS: Patients (median age: 61, 288 men) underwent lobectomy (n=378) or pneumonectomy (n=29). Patients overall survival at 5 and 10-year was 53.2% and 32.6%, respectively. UICC stage distribution was 189 stage I, 104 stage II, 107 stage III and 7 stage IV. Low grade tumor was found in 1 patient, intermediate grade in 275 patients and high grade in 131 patients. KRAS and EGFR mutations, were detected in 34% and 9.6% respectively. Histological grade was significantly correlated with extent of resection (P=0.01), TTF-1 expression (P=10-8), vascular emboli (P=0.03) and EGFR mutations (P=0.01). Mucinous adenocarcinomas were associated with KRAS mutations (P=0.003). At univariate analysis, age, extent of resection, histological grade, pleural invasion, vascular emboli, pathological T and N, and stage, were predictive of survival. At multivariate analysis, age (P=10-4), histological grade (P=0.03) and stage (P=3.10-6) were independent prognostic factors.
CONCLUSIONS: IASLC/ATS/ERS classification of lung adenocarcinomas predicts survival in French population. Histological grade correlates with clinical, pathological and molecular parameters suggesting different oncogenic pathways.
The new histological classification of lung primary adenocarcinoma subtypes is a reliable prognostic marker and identifies tumors with different mutation status: the experience of a French cohort.
Mansuet-Lupo A, Bobbio A, Blons H, Becht E, Ouakrim H, Didelot A, Charpentier MC, Bain S, Marmey B, Bonjour P, Biton J, Cremer I, Dieu-Nosjean MC, Sautès-Fridman C, Régnard JF, Laurent-Puig P, Alifano M, Damotte D. Chest. 2014 Mar
ABSTRACT BACKGROUND: Histological classification of lung adenocarcinoma subtype has a prognostic value in most studies. However, lung adenocarcinoma characteristics differ across countries. Here, we aimed at validating the prognostic value of this classification in a large French series of lung adenocarcinoma.
METHODS: We reviewed 407 consecutive lung adenocarcinomas operated on between 2001 and 2005 and reclassified them according to the IASLC/ATS/ERS classification and subsequently graded into low, intermediate and high grade. We analysed the relevance of this classification according to clinical, pathological, and molecular analysis.
RESULTS: Patients (median age: 61, 288 men) underwent lobectomy (n=378) or pneumonectomy (n=29). Patients overall survival at 5 and 10-year was 53.2% and 32.6%, respectively. UICC stage distribution was 189 stage I, 104 stage II, 107 stage III and 7 stage IV. Low grade tumor was found in 1 patient, intermediate grade in 275 patients and high grade in 131 patients. KRAS and EGFR mutations, were detected in 34% and 9.6% respectively. Histological grade was significantly correlated with extent of resection (P=0.01), TTF-1 expression (P=10-8), vascular emboli (P=0.03) and EGFR mutations (P=0.01). Mucinous adenocarcinomas were associated with KRAS mutations (P=0.003). At univariate analysis, age, extent of resection, histological grade, pleural invasion, vascular emboli, pathological T and N, and stage, were predictive of survival. At multivariate analysis, age (P=10-4), histological grade (P=0.03) and stage (P=3.10-6) were independent prognostic factors.
CONCLUSIONS: IASLC/ATS/ERS classification of lung adenocarcinomas predicts survival in French population. Histological grade correlates with clinical, pathological and molecular parameters suggesting different oncogenic pathways.
