PT  - JOURNAL ARTICLE
AU  - Itami, Hiroe
AU  - Kawaguchi, Takeshi
AU  - Yoshikawa, Daiki
AU  - Watanabe, Takashi
AU  - Terada, Chiyoko
AU  - Okada, Fumi
AU  - Uchiyama, Tomoko
AU  - Takeda, Maiko
AU  - Ishida, Eiwa
AU  - Nishimoto, Yuko
AU  - Okada, Hiroshi
AU  - Kushibe, Keiji
AU  - Sawabata, Noriyoshi
AU  - Ohbayashi, Chiho
TI  - Preference of grade and lymphovascular invasion over invasive size measurement in stage I lung adenocarcinoma
AID  - 10.1136/jclinpath-2021-208053
DP  - 2023 Jul 01
TA  - Journal of Clinical Pathology
PG  - 486--491
VI  - 76
IP  - 7
4099  - http://jcp.bmj.com/content/76/7/486.short
4100  - http://jcp.bmj.com/content/76/7/486.full
SO  - J Clin Pathol2023 Jul 01; 76
AB  - Aims Although it is necessary to measure the invasive size of lung adenocarcinoma with a lepidic component, it is not uncommon to have trouble in measuring the invasive size of lung adenocarcinoma. This study examined whether there were other stronger prognostic factors than invasive size.Methods We characterised the clinicopathological features associated with recurrence-free survival (RFS) of 686 patients with the pathological stage (p-Stage) I lung adenocarcinoma. Moreover, we compared the area under the curve (AUC) values for recurrence between various combinations of pathological-baseline (age & sex & p-Stage based on invasive size) (B(i)) and several prognostic factors, and various combinations of p-baseline based on total tumour size (B(t)) and several prognostic factors.Results AUC showed no significant differences between B(i) & new International Association for the Study of Lung Cancer grade (G) or vascular invasion (V), and B(t) & G or V. AUC was the highest in B & G & lymphatic invasion (L) & V. RFS was significantly shorter in patients with G3 OR L(+) OR V(+) than in those with G≤2 AND L(-) AND V(-) in each p-Stage based on invasive size (p-Stage(i)) and p-Stage based on total tumour size (p-Stage(t)) (p<0.05), and there were no significant differences in RFS between each p-Stage(i) and p-Stage(t).Conclusions In any invasive size or total tumour size of p-Stage I lung adenocarcinoma, G, L and V are more powerful prognostic factors than the size criteria of p-Stage. Therefore, pathologists should focus on these pathological findings.All data relevant to the study are included in the article or uploaded as online supplemental information.