Prognostic impact of lepidic growth in intermediate and high-grade lung adenocarcinoma

BACKGROUND: Grade 1 lung adenocarcinomas, which are characterized by predominantly lepidic growth and less than 20 % high-risk patterns, have a favorable survival rate compared to higher-grade tumors. However, the prognostic relevance of lepidic components in intermediate and high-grade tumors (grades 2-3) remains unclear. We investigated whether lepidic growth impacts survival in grade 2-3 stage I lung adenocarcinomas. METHODS: 479 consecutive patients who underwent curative resection for non-mucinous lung adenocarcinoma in pathologic grade 2-3 and stage I were enrolled in this retrospective, single-center study. The impact of lepidic components and other predictors on survival was assessed in multivariable cox regression. RESULTS: Lepidic growth was present in 300 (62.6 %) tumors. Patients with lepidic-positive tumors were significantly older (median age 67 vs. 65 years, p = 0.015), more frequently never-smokers (22.1 % vs. 9.9 %, p = 0.001), had higher proportions of acinar-predominant (69.0 % vs. 53.1 %, p = 0.001), and fewer solid-predominant tumors (7.0 % vs. 26.8 %, p < 0.001). Median follow-up was 67 months (IQR 47-92). Multivariable Cox analysis demonstrated no significant association between lepidic growth and overall or recurrence-free survival. Factors significantly affecting recurrence-free survival included age 

• Niedermaier, B.
• Rolf, E.
• Allgäuer, M.
• Klotz, L. V.
• Schneider, M. A.
• Yuskaeva, K.
• Eichhorn, M. E.
• Winter, H.