Current Readings: Pathology, Prognosis, and Lung Cancer

The 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma introduced the new categories of adenocarcinoma in situ, minimally invasive adenocarcinoma, and invasive mucinous adenocarcinoma, and replaced the category of mixed subtype adenocarcinoma with lepidic, acinar, papillary, micropapillary, and solid predominant adenocarcinoma. The aim of this manuscript is to evaluate whether the new classification can be applied successfully in determining prognosis of surgically resected patients. Six consecutive clinicopathologic studies using the new classification that were published between spring 2011 and fall 2012 were reviewed. Overall, they demonstrated excellent outcome for adenocarcinoma in situ and minimally invasive adenocarcinoma; intermediate outcome for lepidic, acinar, and papillary predominant adenocarcinoma; and poor outcome for solid and micropapillary predominant adenocarcinoma and invasive mucinous adenocarcinoma. As the new classification remains a proposal at this time, it is hoped that thoracic surgeons will play a leading role in its worldwide dissemination for clinical care and research.