ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2024
Novel Insights Into the International Association for the Study of Lung Cancer Grading System for Lung Adenocarcinoma.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- A multimodal AI biomarker PATH-ORACLE improves prediction of recurrence in stage I lung adenocarcinoma.Immuno-oncology technology · 2026Article
- A radiomics-based machine learning model for the preoperative differentiation of lung adenocarcinoma subtypes.Quantitative imaging in medicine and surgery · 2026Article
- What's new in neoplastic pulmonary pathology 2026: updates on grading, staging and molecular testing.Journal of pathology and translational medicine · 2026Article
- Application of SHAP visualization and nomogram based on PET/CT radiomics combined models for risk stratification in high-grade invasive lung adenocarcinoma.Journal of translational medicine · 2026Article
- Development of a model to predict high-risk histopathological features in early T-stage lung adenocarcinoma using thin-slice CT and FDG-PET/CT parameters for selecting optimal candidates for sub-lobar resection.Journal of thoracic disease · 2026Article
- Article
- Customized transformer for lymph node metastasis prediction from lung adenocarcinoma histology in a multicentric study.NPJ precision oncology · 2025Article
- Visceral Pleural Invasion as a Determinant of Surgical Strategy in Non-Small Cell Lung Cancer: A Multicenter Study.Cancers · 2025Article
- Robotic-assisted bronchoscopy for histopathologic subtyping of primary lung adenocarcinoma.Lung cancer (Amsterdam, Netherlands) · 2025Article
- Machine learning algorithms for predicting malignancy grades of lung adenocarcinoma and guiding treatments: CT radiomics-based comparisons.Journal of thoracic disease · 2025Article
- Clinical implication of tumor spread through air spaces in stage IA lung adenocarcinoma: prognostic impact and association with the International Association for the Study of Lung Cancer (IASLC) grade.Translational lung cancer research · 2025Article
- Downregulation of tropomyosin 2 promotes the progression of lung adenocarcinoma by regulating neutrophil infiltration through neutrophil elastase.Cell death & disease · 2025Article
- Differentiating high-grade patterns and predominant subtypes for IASLC grading in invasive pulmonary adenocarcinoma using radiomics and clinical-semantic features.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Article
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9 authors.
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Abstract
The new grading system for lung adenocarcinoma proposed by the International Association for the Study of Lung Cancer (IASLC) defines prognostic subgroups on the basis of histologic patterns observed on surgical specimens. This study sought to provide novel insights into the IASLC grading system, with particular focus on recurrence-specific survival (RSS) and lung cancer-specific survival among patients with stage I adenocarcinoma. Under the IASLC grading system, tumors were classified as grade 1 (lepidic predominant with <20% high-grade patterns [micropapillary, solid, and complex glandular]), grade 2 (acinar or papillary predominant with <20% high-grade patterns), or grade 3 (≥20% high-grade patterns). Kaplan-Meier survival estimates, pathologic features, and genomic profiles were investigated for patients whose disease was reclassified into a higher grade under the IASLC grading system on the basis of the hypothesis that they would strongly resemble patients with predominant high-grade tumors. Overall, 423 (29%) of 1443 patients with grade 1 or 2 tumors classified based on the predominant pattern-based grading system had their tumors upgraded to grade 3 based on the IASLC grading system. The RSS curves for patients with upgraded tumors were significantly different from those for patients with grade 1 or 2 tumors (log-rank P < .001) but not from those for patients with predominant high-grade patterns (P = .3). Patients with upgraded tumors had a similar incidence of visceral pleural invasion and spread of tumor through air spaces as patients with predominant high-grade patterns. In multivariable models, the IASLC grading system remained significantly associated with RSS and lung cancer-specific survival after adjustment for aggressive pathologic features such as visceral pleural invasion and spread of tumor through air spaces. The IASLC grading system outperforms the predominant pattern-based grading system and appropriately reclassifies tumors into higher grades with worse prognosis, even after other pathologic features of aggressiveness are considered.
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