Background and Objectives Adenocarcinoma patterns could be grouped based on clinical behaviors: low- (lepidic), intermediate- (papillary or acinar), and high-grade (micropapillary and solid). We analyzed the impact of the second predominant pattern (SPP) on disease-free survival (DFS).Methods We retrospectively collected data of surgically resected stage I and II adenocarcinoma. Selection criteria: anatomical resection with lymphadenectomy and pathological N0. Pure adenocarcinomas and mucinous subtypes were excluded. Recurrence rate and factors affecting DFS were analyzed according to the SPP focusing on intermediate-grade predominant pattern adenocarcinomas.Results Among 270 patients, 55% were male. The mean age was 68.3 years. SPP pattern appeared as follows: lepidic 43.0%, papillary 23.0%, solid 14.4%, acinar 11.9%, and micropapillary 7.8%. The recurrence rate was 21.5% and 5-year DFS was 71.1%. No difference in DFS was found according to SPP (p = .522).In patients with high-grade SPP, the percentage of SPP, age, and tumor size significantly influenced DFS (p = .016). In patients with lepidic SPP, size, male gender, and lymph-node sampling (p = .005; p = .014; p = .038, respectively) significantly influenced DFS.Conclusions The impact of SPP on DFS is not homogeneous in a subset of patients with the intermediate-grade predominant patterns. The influence of high-grade SPP on DFS is related to its proportion in the tumor.
Prognostic impact of lung adenocarcinoma second predominant pattern from a large European database / Bertoglio, Pietro; Querzoli, Giulia; Ventura, Luigi; Aprile, Vittorio; Cattoni, Maria A; Nachira, Dania; Lococo, Filippo; Rodriguez Perez, Maria; Guerrera, Francesco; Minervini, Fabrizio; Gnetti, Letizia; Bacchin, Diana; Franzi, Francesca; Rindi, Guido; Bellafiore, Salvatore; Femia, Federico; Viti, Andrea; Bogina, Giuseppe S; Kestenholz, Peter; Ruffini, Enrico; Paci, Massimiliano; Margaritora, Stefano; Imperatori, Andrea S; Lucchi, Marco; Ampollini, Luca; Terzi, Alberto C. - In: JOURNAL OF SURGICAL ONCOLOGY. - ISSN 2674-3000. - (2020). [10.1002/jso.26292]
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