Barletta et al developed a simple score for grading lung adenocarcinomas. This can help to identify a tumor that may benefit from more aggressive management. The authors are from Brigham and Women's Hospital and Massachusetts General Hospital in Boston.
Patient selection: lung adenocarcinoma
Parameters:
(1) growth pattern
(2) nuclear atypia
Parameter |
Finding |
Points |
growth pattern |
glandular areas (solid < 90%) |
1 |
|
solid growth >= 90% |
2 |
nuclear atypia |
mild to moderate |
1 |
|
high |
2 |
where:
• Elements resemble the Bloom Richardson score for breast cancer. A third parameter for mitotic count per 10 high power fields had a high p value in the multivariate analysis.
• Scoring of 0 or 1 (vs 1 or 2) would be an alternative method.
total score =
= SUM(points for the 2 parameters)
Interpretation:
• minimum score: 2
• maximum score: 4
• The higher the score the higher the grade.
Total Score |
Grade |
Overall Survival at 4 Years |
2 |
well-differentiated |
70% |
3 |
moderately differentiated |
47% |
4 |
poorly differentiated |
15% |
where:
• Overall survival for the poorly differentiated group was 0% at 78 months.
• Survival of well differentiated and moderately differentiated merged at 35% at 10 years (120 months)
Specialty: Hematology Oncology, Surgery, general, Pulmonology
ICD-10: ,