The new IASLC-ATS-ERS lung adenocarcinoma classification: What the surgeon should know Journal Article


Authors: Eguchi, T.; Kadota, K.; Park, B. J.; Travis, W. D.; Jones, D. R.; Adusumilli, P. S.
Article Title: The new IASLC-ATS-ERS lung adenocarcinoma classification: What the surgeon should know
Abstract: In 2011, a new histologic classification of lung adenocarcinomas was proposed from a joint working group of the International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society, based on the recommendation of an international and multidisciplinary panel. This classification proposed a method of comprehensive histologic subtyping (lepidic, acinar, papillary, micropapillary, and solid pattern) based on semiquantitative assessment of histologic patterns (in 5% increments), with the ultimate goal of choosing a single, predominant pattern. Prognostic subsets could then be described for the classification. Patients with completely resected adenocarcinoma in situ and minimally invasive adenocarcinomas experienced low risk of recurrence. Patients with micropapillary or solid predominant tumors have a high risk of recurrence or cancer-related death. Patients with acinar and papillary predominant tumors comprise an intermediate-risk group. Herein, we review the outline of the proposed International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society classification, a summary of published validation studies of this new classification, and then discuss the key surgical issues; we mainly focused on limited resection as an adequate treatment for early-stage lung adenocarcinomas, as well as preoperative and intraoperative diagnoses. We also review the published studies that identified the importance of histologic subtypes in predicting recurrence, both rates and patterns, in early-stage lung adenocarcinomas. This new classification for the most common type of lung cancer is useful for surgeons, as its implementation would require only hematoxylin-and-eosin histology slides, which is the common type of stain used in hospitals. It can be implemented with routine pathology evaluation and with no additional costs. © 2014 Elsevier Inc.
Keywords: lung adenocarcinoma; histologic classification; micropapillary; limited resection; small lung nodules
Journal Title: Seminars in Thoracic and Cardiovascular Surgery
Volume: 26
Issue: 3
ISSN: 1043-0679
Publisher: Elsevier Inc.  
Date Published: 2014-01-01
Start Page: 210
End Page: 222
Language: English
DOI: 10.1053/j.semtcvs.2014.09.002
PROVIDER: scopus
PMCID: PMC4272758
PUBMED: 25527015
DOI/URL:
Notes: Export Date: 4 May 2015 -- Source: Scopus
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MSK Authors
  1. William D Travis
    743 Travis
  2. Bernard J Park
    263 Park
  3. Kyuichi Kadota
    85 Kadota
  4. David Randolph Jones
    417 Jones
  5. Takashi   Eguchi
    71 Eguchi