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Predictive scoring of high-grade histology among early-stage lung cancer patients: The MOSS score

 Wongi Woo  ;  Yoon Jin Cha  ;  Chul Hwan Park  ;  Duk Hwan Moon  ;  Sungsoo Lee 
 THORACIC CANCER, Vol.14(19) : 1865-1873, 2023-07 
Journal Title
Issue Date
Adenocarcinoma* / pathology ; Carcinoma, Non-Small-Cell Lung* / pathology ; Humans ; Lung Neoplasms* / pathology ; Lung Neoplasms* / surgery ; Male ; Neoplasm Staging ; Prognosis ; Retrospective Studies
International Association for the Study of Lung Cancer ; adenocarcinoma ; non-small cell lung cancer ; prediction model ; preoperative factors
Background: Poor prognosis associated with adenocarcinoma of International Association for the Study of Lung Cancer (IASLC) grade 3 has been recognized. In this study we aimed to develop a scoring system for predicting IASLC grade 3 based before surgery.Methods: Two retrospective datasets with significant heterogeneity were used to develop and evaluate a scoring system. The development set was comprised of patients with pathological stage I nonmucinous adenocarcinoma and they were randomly divided into training (n = 375) and validation (n = 125) datasets. Using multivariate logistic regression, a scoring system was developed and internally validated. Later, this new score was further tested in the testing set which was comprised of patients with clinical stage 0-I non-small cell lung cancer (NSCLC) (n = 281).Results: Four factors that were related to IASLC grade 3 were used to develop the new scoring system the MOSS score; male (M, point 1), overweight (O, point 1), size>10 mm (S, point 1), and solid lesions (S, point 3). Predictability of IASLC grade 3 increased from 0.4% to 75.2% with scores from 0 to 6. The area under the curve (AUC) of the MOSS was 0.889 and 0.765 for the training and validation datasets, respectively. The MOSS score exhibited similar predictability in the testing set (AUC: 0.820).Conclusion: The MOSS score, which combines preoperative variables, can be used to identify high-risk early-stage NSCLC patients with aggressive histological features. It can support clinicians in determining a treatment plan and surgical extent. Further refinement of this scoring system with prospective validation is needed.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Moon, Duk Hwan(문덕환)
Park, Chul Hwan(박철환) ORCID logo https://orcid.org/0000-0002-0004-9475
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
Cha, Yoon Jin(차윤진) ORCID logo https://orcid.org/0000-0002-5967-4064
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