WCLC 2025 - Posters & ePosters-EP.06.29 Prognostic Impact of Lepidic Growth in Intermediate and High-Grade Lung Adenocarcinoma

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This study by Niedermaier et al. investigated the prognostic impact of lepidic growth patterns in stage I intermediate and high-grade (IASLC grade 2-3) lung adenocarcinomas. The cohort included 479 patients who underwent primary resection between 2010 and 2020, with a median follow-up of 67 months. Histologic growth patterns were semi-quantitatively assessed according to WHO criteria.<br /><br />The key finding was that the presence of lepidic growth components did not significantly affect overall or recurrence-free survival in this patient population. Survival analyses showed no statistical difference between patients with or without lepidic growth across total cohort and within grade 2 and grade 3 subgroups. In contrast, established invasion-related factors such as pathologic stage IB, higher histologic grade, lymphatic invasion, and solid growth components were associated with worse prognosis on multivariable Cox regression models. Lepidic growth presence or extent showed no independent prognostic relevance.<br /><br />Differences in previous literature regarding the implications of lepidic growth might be explained by population heterogeneity, including variations between European and Asian patients in histological subtypes, environmental risk factors, and genetic profiles. This study's large European cohort emphasizes that, unlike lower-grade lesions where lepidic patterns may confer better outcomes, in higher-grade lung adenocarcinomas, prognosis depends predominantly on invasive features rather than the presence of lepidic components.<br /><br />In summary, lepidic growth does not provide prognostic information for intermediate and high-grade stage I lung adenocarcinomas. Clinical and pathological evaluation should instead focus on invasion-associated variables to guide prognosis and management in this subgroup.

Asset Subtitle

Benedikt Niedermaier

Meta Tag

Speaker Benedikt Niedermaier

Topic Pathology and Biomarkers

Keywords

lepidic growth pattern

stage I lung adenocarcinoma

intermediate and high-grade tumors

IASLC grade 2-3

prognostic impact

overall survival

recurrence-free survival

histologic growth patterns

invasion-related factors

European lung cancer cohort