TY - JOUR T1 - Clinicopathological predictors of survival in resected primary lung adenocarcinoma JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 310 LP - 315 DO - 10.1136/jclinpath-2021-207388 VL - 75 IS - 5 AU - Hiral Jhala AU - Leanne Harling AU - Alberto Rodrigo AU - Daisuke Nonaka AU - Emma Mclean AU - Wen Ng AU - Lawrence Okiror AU - Andrea Bille Y1 - 2022/05/01 UR - http://jcp.bmj.com/content/75/5/310.abstract N2 - Aims Primary lung adenocarcinoma consists of a spectrum of clinical and pathological subtypes that may impact on overall survival (OS). Our study aims to evaluate the impact of adenocarcinoma subtype and intra-alveolar spread on survival after anatomical lung resection and identify different prognostic factors based on stage and histological subtype.Methods Newly diagnosed patients undergoing anatomical lung resections without induction therapy, for pT1-3, N0-2 lung adenocarcinoma from April 2011 to March 2013, were included. The effect of clinical–pathological factors on survival was retrospectively assessed.Results Two hundred and sixty-two patients were enrolled. The 1-year, 3-year and 5-year OS were 88.8%, 64.3% and 51.1%, respectively. Univariate analysis showed lymphovascular, parietal pleural and chest wall invasion to confer a worse 1-year and 5-year prognosis (all p<0.0001). Solid predominant adenocarcinomas exhibited a significantly worse OS (p=0.014). Multivariate analysis did not identify solid subtype as an independent prognostic factor; however, identified stage >IIa, lymphovascular invasion (p=0.002) and intra-alveolar spread (p=0.009) as significant independent predictors of worse OS. Co-presence of intra-alveolar spread and solid predominance significantly reduced OS. Disease-free survival (DFS) was reduced with parietal pleural (p=0.0007) and chest wall invasion (p<0.0001), however, adenocarcinoma subtype had no significant impact on DFS.Conclusions Our study demonstrates that solid predominant adenocarcinoma, intra-alveolar spread and lymphovascular invasion confer a worse prognosis and should be used as a prognostic tool to determine appropriate adjuvant treatment.Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. The retrospective database including all data collected will be available upon reasonable request. ER -