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Prognosis of resected invasive mucinous adenocarcinoma compared with the IASLC histologic grading system for invasive nonmucinous adenocarcinoma: Surgical database study in the TKIs era in Korea

 Wongi Woo  ;  Young Ho Yang  ;  Yoon Jin Cha  ;  Duk Hwan Moon  ;  Hyo Sup Shim  ;  Arthur Cho  ;  Bong Jun Kim  ;  Ha Eun Kim  ;  Byung Jo Park  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Hyo Chae Paik  ;  Sungsoo Lee  ;  Chang Young Lee 
 THORACIC CANCER, Vol.13(23) : 3310-3321, 2022-12 
Journal Title
Issue Date
Adenocarcinoma of Lung* / pathology ; Adenocarcinoma of Lung* / surgery ; Adenocarcinoma* / pathology ; Adenocarcinoma, Mucinous* / surgery ; Humans ; Lung Neoplasms* / drug therapy ; Neoplasm Staging ; Prognosis ; Retrospective Studies
classification ; lung adenocarcinoma ; mucinous adenocarcinoma ; pathologic subtype ; prognosis
Background: The prognosis of invasive mucinous adenocarcinoma (IMA) remains controversial and should be clarified by comparison with the International Association for the Study of Lung Cancer (IASLC) histologic grading system for invasive nonmucinous adenocarcinoma (INMA).

Methods: This study included patients with IMA who underwent curative resection. Their clinicopathological outcomes were compared with those of patients with INMA. Propensity score matching was performed to compare the prognosis of IMA with IASLC grade 2 or 3. Kaplan-Meier survival curves and log-rank tests were used to analyze recurrence-free survival (RFS) and overall survival (OS).

Results: The prognoses of IMA and IASLC grade 2 were similar in terms of RFS and OS. Although patients with IMA had better RFS than patients with IASLC grade 3, the OS was not significantly different. After propensity score matching, IMA demonstrated similar RFS to IASLC grade 2 but superior to IASLC grade 3; there was no difference in the OS compared with grades 2/3. Multivariate analysis revealed that tumor size (hazard ratio [HR] = 1.20, p = 0.028), lymphovascular invasion (HR = 127.5, p = 0.003), and maximum standardized uptake value (HR = 1.24, p = 0.005) were poor prognostic predictors for RFS. Patients with IMA demonstrated RFS similar to and significantly better than that of patients with IASLC grades 2 and 3, respectively. For OS, IMA prognosis was between that of IASLC grades 2 and 3.

Conclusions: Since the prognosis of IMA among lung adenocarcinomas appears to be relatively worse, further clinical studies investigating IMA-specific treatment and follow-up plans are necessary to draw more inferences.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Kim, Ha Eun(김하은)
Moon, Duk Hwan(문덕환)
Park, Byung Jo(박병조)
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Shim, Hyo Sup(심효섭) ORCID logo https://orcid.org/0000-0002-5718-3624
Yang, Young Ho(양영호)
Woo, Wongi(우원기) ORCID logo https://orcid.org/0000-0002-0053-4470
Lee, Sung Soo(이성수) ORCID logo https://orcid.org/0000-0001-8998-9510
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
Cha, Yoon Jin(차윤진) ORCID logo https://orcid.org/0000-0002-5967-4064
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