Prognostic significance of the IASLC/ATS/ERS classification in Chinese patients—A single institution retrospective study of 292 lung adenocarcinoma

BACKGROUND: A new classification of pulmonary adenocarcinoma has been recently proposed by the International Association for the Study of Lung Cancer, American Thoracic Society and European Respiratory Society (IASLC/ATS/ERS). This study was undertaken in an attempt to explore the clinical implication of this new classification in Chinese patients. METHODS: Two hundred ninety-two lung adenocarcinomas were reclassified strictly according to the IASLC/ATS/ERS classification by two pathologists, independently. Kaplan-Meier and Cox regression analyses were used to analyze the correlation between the new classification and patients' prognosis. RESULTS: We confirmed three groups with different outcomes. Both AIS and MIA had 100% 5-year disease-free survival rate and 100% 5-year overall survival rate. Lepidic, acinar, and papillary as well as variants of invasive adenocarcinoma had intermediate prognosis. Solid and micropapillary cases had poor prognosis (DFS: P < 0.001, OS: P = 0.002). After controlling the clinicopathological factors, the new classification was identified as an independent prognostic factor in patients' disease-free survival and overall survival. CONCLUSIONS: We have demonstrated a valuable prognostic role of the new classification in Chinese patients. This new classification is valuable of screening out patients with high risk of recurrence to receive postoperative adjuvant therapy.