Controverse. Le traitement des CBNPC guidé par l'histologie : et si le critère choisi n'était pas le bon ?

Several studies shed light on a the therapeutic decision concept guided by histology. These latter are questionable on the methodological issues, moreover they sometimes enveil opposed results. Besides, the histologic taking and analysis methods are not standardized and so some question stay unanswered : The reliability of bronchial biopsies by report to the surgical ones? The quality of the histological diagnosis considering the conflicts between pathologists? Interest and place of immunohistotochemistry? Limitation of alone histological entity adenocarcinoma despite their expression variability in molecular biology. To answer these questions we will need to classify the prospective trials on pathology data and treat as a function of the histological and molecular biology results. Then we just need to modify the AMM which today forces us to treat all the adenocarcinoma and squamous cell carcinoma the same way and then let the place to customised treatment, based on molecular characteristics of each individual tumor, that do not recover the simplistic adenocarcinoma/squamous cell carcinoma dichotomy.