2024 World Conference on Lung Cancer (WCLC) - Posters-P4.07E.01 A Revised International Association for the Study of Lung Cancer Grading System: The Inclusion of Invasive Mucinous Adenocarcinomas

P4.07E.01 A Revised International Association for the Study of Lung Cancer Grading System: The Inclusion of Invasive Mucinous Adenocarcinomas

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The study by Hanyue Li, Lei Xu, and Wentao Fang from the Department of Thoracic Surgery at Shanghai Chest Hospital examines a revised grading system by the International Association for the Study of Lung Cancer (IASLC) to include invasive mucinous adenocarcinoma (LIMA) in the evaluation of lung invasive adenocarcinoma (ADC). The research aims to assess the validity of incorporating LIMA into the existing IASLC grading system.<br /><br />The study retrospectively analyzed data from 553 ADC patients from Shanghai Chest Hospital and 6,962 patients from the SEER database. LIMA was integrated into the IASLC grading system, reclassifying tumors into different grades based on predominant patterns and the presence of high-grade features. The effectiveness of the revised grading system was measured using metrics such as the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves, and area under the curves (AUCs). Kaplan-Meier methods and log-rank tests were used to evaluate overall survival (OS).<br /><br />The results indicated that LIMA was included as a predominant tumor pattern in the IASLC system. Tumors with less than 20% high-grade patterns were categorized as Grade 2 (moderately differentiated). The C-index and AUCs of the revised system were 0.754 and 0.729 in the training cohort, and 0.716 and 0.682 in the validation cohort, respectively, demonstrating its efficiency. The revised system showed distinct OS rates in different grades, particularly evident in the 5-year OS rates: 88.6% for Grade I, 76.1% for Grade II, and 65.5% for Grade III in the training cohort. Similar trends were observed in the validation cohort.<br /><br />The study concludes that the revised IASLC grading system effectively predicts outcomes in lung invasive ADC and suggests that integrating LIMA enhances its applicability and prognostic value.

Asset Subtitle

hanyue li

Meta Tag

Speaker hanyue li

Topic Early-Stage NSCLC

Keywords

Lung Cancer

Invasive Mucinous Adenocarcinoma

IASLC Grading System

Prognostic Value

Thoracic Surgery

Shanghai Chest Hospital

Concordance Index

Overall Survival

Kaplan-Meier

SEER Database