Modified Scar Grade of Maeshima et al for Small Peripheral Lung Adenocarcinomas

Description

Maeshima et al used a grading system for small peripheral lung adenocarcinomas based on the degree of desmoplasia. This can help separate tumors into those with good and poor prognosis. The authors are from the National Cancer Center Hospital in Tokyo.

Patient selection: primary peripheral lung adenocarcinoma, measuring <= 30 mm (3 cm) in diameter

Parameters:

(1) amount of desmoplasia

(2) histologic pattern of adenocarcinoma

Degree of Desmoplasia	Grade
none	1
sparse	2
dense desmoplasia with diameter <= 10 mm	3
dense desmoplasia with diameter > 10 mm	4

Histologic Pattern	Subtypes of Grade 1
broncho-alveolar carcinoma with alveolar septal thickening;, but without collapse and without fibrosis	1A
broncho-alveolar carcinoma, with foci of collapse	1B
adenocarcinoma with papillary, acinar or solid component but without fibrosis	1C

Grade of Tumor	Survival Rate at 5 Years After Surgical Resection
Grade 1	100%
Grade 2	92%
Grade 3	65%
Grade 4	52%

from Table 2, page 2549 and Figure 2, page 2550

where:

• The survival rates appear very good. About half the tumors were <= 2 cm in diameter. About a third of the patients had lymph node metastases and these patients had a 5 year survival rate of 37%.

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Description

Specialty

ICD-10