دورية أكاديمية

A Simplified Version of the IASLC Grading System for Invasive Pulmonary Adenocarcinomas With Improved Prognosis Discrimination

التفاصيل البيبلوغرافية
العنوان: A Simplified Version of the IASLC Grading System for Invasive Pulmonary Adenocarcinomas With Improved Prognosis Discrimination
المؤلفون: Bossé, Yohan, Gagné, Andréanne, Althakfi, Wajd A., Orain, Michèle, Couture, Christian, Trahan, Sylvain, Pagé, Sylvain, Joubert, David, Fiset, Pierre O., Desmeules, Patrice, Joubert, Philippe
المصدر: American Journal of Surgical Pathology ; volume 47, issue 6, page 686-693 ; ISSN 0147-5185
بيانات النشر: Ovid Technologies (Wolters Kluwer Health)
سنة النشر: 2023
الوصف: Tumor grading enables better management of patients and treatment options. The International Association for the Study of Lung Cancer (IASLC) Pathology Committee has recently released a 3-tier grading system for invasive pulmonary adenocarcinoma consisting of predominant histologic patterns plus a cutoff of 20% of high-grade components including solid, micropapillary, and complex glandular patterns. The goal of this study was to validate the prognostic value of the new IASLC grading system and to compare its discriminatory performance to the predominant pattern–based grading system and a simplified version of the IASLC grading system without complex glandular patterns. This was a single-site retrospective study based on a 20-year data collection of patients that underwent lung cancer surgery. All invasive pulmonary adenocarcinomas confirmed by the histologic review were evaluated in a discovery cohort (n=676) and a validation cohort (n=717). The median duration of follow-up in the combined dataset (n=1393) was 7.5 years. The primary outcome was overall survival after surgery. The 3 grading systems had strong and relatively similar predictive performance, but the best parsimonious model was the simplified IASLC grading system (log-rank P =1.39E−13). The latter was strongly associated with survival in the validation set ( P =1.1E−18) and the combined set ( P =5.01E−35). We observed a large proportion of patients upgraded to the poor prognosis group using the IASLC grading system, which was attenuated when using the simplified IASLC grading system. In conclusion, we identified a histologic simpler classification for invasive pulmonary adenocarcinomas that outperformed the recently proposed IASLC grading system. A simplified grading system is clinically convenient and will facilitate widespread implementation.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1097/pas.0000000000002040
DOI: 10.1097/PAS.0000000000002040
الإتاحة: https://doi.org/10.1097/pas.0000000000002040Test
حقوق: http://creativecommons.org/licenses/by-nc-nd/4.0Test/ http://creativecommons.org/licenses/by-nc-nd/4.0Test/
رقم الانضمام: edsbas.123DD53E
قاعدة البيانات: BASE