ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2020
A Grading System for Invasive Pulmonary Adenocarcinoma: A Proposal From the International Association for the Study of Lung Cancer Pathology Committee.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 301 papers, 1 of them a synthesis that pooled it.
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Who cites it
301 citing papers in PubMed, 1 synthesis or guideline pooled it, 521 citations in OpenAlex.
- Prognostic impact of the newly revised IASLC proposed grading system for invasive lung adenocarcinoma: a systematic review and meta-analysis.World journal of surgical oncology · 2024Pooled it
- A multimodal AI biomarker PATH-ORACLE improves prediction of recurrence in stage I lung adenocarcinoma.Immuno-oncology technology · 2026Article
- Article
- The Efficacy of Adjuvant EGFR-TKI Therapy for Stage IA Lung Adenocarcinoma with EGFR Mutations: A Retrospective Cohort Study.Annals of surgical oncology · 2026Article
- Integration of Histologic Pattern Classifiers and Graph Convolutional Networks for Prognostic Prediction in Lung Adenocarcinoma.JTO clinical and research reports · 2026Article
- Evaluation of grading systems among pulmonary adenocarcinomas: architectural grade combined with STAS is superior to others - a single centre study.Virchows Archiv : an international journal of pathology · 2026Article
- What's new in neoplastic pulmonary pathology 2026: updates on grading, staging and molecular testing.Journal of pathology and translational medicine · 2026Article
- Conventional chest CT features are associated with Ki-67 labeling index in lung adenocarcinoma: a single-center retrospective radiopathologic study.Journal of thoracic disease · 2026Article
- Invasive mucinous adenocarcinoma of the lung: integrating molecular landscape, imaging phenotypes, and translational therapeutic strategies.Translational lung cancer research · 2026Review
- Biopsies Can Predict Lung Adenocarcinoma IASLC Grade: A New Proposal and Grading Pitfalls.JTO clinical and research reports · 2026Article
- Gene Expression Clustering of Lung Adenocarcinoma Tumors as a Prognosis Tool to Infer Progression-Free Survival.JTO clinical and research reports · 2026Article
- A retrospective cohort study integrating invasive mucinous adenocarcinoma into the IASLC grading system for lung adenocarcinoma.Translational lung cancer research · 2026Article
- Prognostic Impact of Inadequate Lymph Node Evaluation in Early-Stage Lung Adenocarcinoma with Micropapillary or Solid Components.Annals of surgical oncology · 2026Article
- FigATree: a novel framework for histological subtyping and grading of lung adenocarcinoma.Virchows Archiv : an international journal of pathology · 2026Article
- GAN-generated target reconstruction CT radiomics for prediction of the novel IASLC grading of pulmonary adenocarcinoma.Journal of thoracic disease · 2026Article
- From synoptic to structured reporting: real-world implementation and evaluation of a pathology reporting tool in lung cancer.Virchows Archiv : an international journal of pathology · 2026Article
- Observational
- Prognostic Effect of TTF-1 Expression and Histopathology in the Patients with Advanced Lung Adenocarcinoma Treated with Immunochemotherapy.The Kobe journal of medical sciences · 2026Article
- Clinicopathological and Prognostic Disparities in Part-Solid Versus Pure Solid Pulmonary Nodules as Early-Stage Lung Adenocarcinoma.Thoracic cancer · 2026Article
- Optimizing surgical decision-making for lung adenocarcinoma by preoperatively identifying pathological high-risk factors: retrospective development and prospective validation of a deep learning model.International journal of surgery (London, England) · 2026Article
241 more citing papers are in PubMed but not listed here.
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Authors and funding
44 authors at 20 institutions in 15 countries.
Funding
Abstract
introductionA grading system for pulmonary adenocarcinoma has not been established. The International Association for the Study of Lung Cancer pathology panel evaluated a set of histologic criteria associated with prognosis aimed at establishing a grading system for invasive pulmonary adenocarcinoma.
methodsA multi-institutional study involving multiple cohorts of invasive pulmonary adenocarcinomas was conducted. A cohort of 284 stage I pulmonary adenocarcinomas was used as a training set to identify histologic features associated with patient outcomes (recurrence-free survival [RFS] and overall survival [OS]). Receiver operating characteristic curve analysis was used to select the best model, which was validated (n = 212) and tested (n = 300, including stage I-III) in independent cohorts. Reproducibility of the model was assessed using kappa statistics.
resultsThe best model (area under the receiver operating characteristic curve [AUC] = 0.749 for RFS and 0.787 for OS) was composed of a combination of predominant plus high-grade histologic pattern with a cutoff of 20% for the latter. The model consists of the following: grade 1, lepidic predominant tumor; grade 2, acinar or papillary predominant tumor, both with no or less than 20% of high-grade patterns; and grade 3, any tumor with 20% or more of high-grade patterns (solid, micropapillary, or complex gland). Similar results were seen in the validation (AUC = 0.732 for RFS and 0.787 for OS) and test cohorts (AUC = 0.690 for RFS and 0.743 for OS), confirming the predictive value of the model. Interobserver reproducibility revealed good agreement (k = 0.617).
conclusionsA grading system based on the predominant and high-grade patterns is practical and prognostic for invasive pulmonary adenocarcinoma.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.