Low-Malignant-Potential Adenocarcinoma: A Histological Category with a Significantly Better Prognosis than Other Solid Adenocarcinomas at IA Stage
Notice bibliographique
Résumé
Introduction: Low-malignant-potential adenocarcinoma has been defined as a type of non-mucinous tumor, which has a total tumor size measuring ≤ 3 cm, exhibits ≥ 15% lepidic growth, lacks non-predominant high-grade patterns (≥10% cribriform, ≥5% micropapillary, ≥5% solid), has an absence of angiolymphatic or visceral pleural invasion, spread through air spaces (STAS), necrosis and >1 mitosis per 2 mm2. The aim of this study is to validate, with regard to cancer-specific survival (CSS) and disease-free survival (DFS), the proposed definition of LMP adenocarcinoma in an independent external cohort of lung adenocarcinoma patients having undergone surgical resection, and having presented with a long follow-up period. Methods: Clinicopathological characteristics of patients who underwent lung resection for adenocarcinoma from 1 January 2005 to 31 December 2014 were retrospectively analyzed. Patients with ground-glass opacity (GGO) and part-solid tumors, minimally invasive adenocarcinoma (MIA), adenocarcinoma in situ (AIS), tumors ≥5 cm in size, nodal involvement and/or distant metastases, patients who underwent neoadjuvant treatment, and those who had an incomplete follow-up or a follow-up shorter than 60 months were excluded. The proposed criteria for low-malignant-potential adenocarcinoma (LMPA) were tumor size ≤ 3 cm, invasive size ≥ 0,5 cm, lepidic growth ≥ 15%, and absence of the following: mitosis (>1 per 2 mm2), mucinous subtype, angiolymphatic invasion, visceral pleural invasion, spread through air spaces (STAS) and tumor necrosis. End points were disease-free survival (DFS) and cancer-specific survival (CSS). The log-rank test was used to assess differences between subgroups. Results: Out of 80 patients meeting the proposed criteria, 14 (17.5%) had the LMPA characteristics defined. The mean follow-up time was 67 ± 39 months. A total of 19 patients died, all in the non-LMPA category, and 33 patients experienced recurrence: 4 (28.5%) with LMPA and 29 (43.9%) with non-LMPA. Log-rank analysis showed 100% 10-year CSS for patients with LMPA and 77.4% for patients without LMPA, with this difference being statistically significant (p-value = 0.047). Univariate analysis showed a significant association with the cStage (AJCC eighth edition), both for CSS (p value = 0.005) and DFS (p-value = 0.003). LMPA classification did not show a statistically significant impact on CSS and DFS, likely due to the limited number of events (CSS p-value = 0.232 and DFS p-value = 0.213). No statistical association was found for CSS and DFS with pT, the number of resected nodes (< or >10) or the number of resected N2 stations (< or >2). Conclusions: Our study confirmed the prognostic role of LMPA features, with a low risk of recurrence and a good CSS and DFS. The criteria for diagnosis are replicable and feasible for application. The clinical implications of these findings, such as pre-operative prediction and surveillance scheduling, may be the topic of future prospective studies.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».