title: The prognostic and predictive value of solid subtype in invasive lung adenocarcinoma.
abstract: A total of 1039 stage I-III invasive lung adenocarcinoma including 186 solid subtype patients who have undergone radical resection were assessed for clinicopathologic characteristics, status of common driver mutations, pattern of recurrence, recurrence-free survival (RFS), overall survival (OS), post-recurrence survival (PRS) and predictive value for adjuvant chemotherapy and EGFR tyrosine kinase inhibitors (TKIs). Solid predominant adenocarcinomas were more likely to have initial distant recurrences than non-solid subtype invasive adenocarcinomas (P = 0.018). In univariate analysis, solid predominant adenocarcinoma patients had significantly worse RFS (P < 0.001), OS (P < 0.001) and PRS (P = 0.010). Multivariate analysis adjusting for clinicopathologic variables and mutational status showed that solid subtype was an independent poor prognostic factor (odds ratio = 1.876, 95% confidence interval: 1.291-3.158; P = 0.003) and an independent negative predictor for stage II-III patients undergoing adjuvant chemotherapy (odds ratio = 2.020, 95% confidence interval: 1.291-3.158; P = 0.002). In EGFR-mutated solid predominant lung adenocarcinoma patients who experienced disease recurrence, the response rate to EGFR TKIs was only 37.5%. In radically resected invasive lung adenocarcinoma, solid subtype was an independent poor prognostic factor and negative predictor for adjuvant chemotherapy.
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: 1] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China [2] Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Yunjian
authors.initials: Y
authors.lastname: Pan
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Deng
authors.initials: D
authors.lastname: Cai
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Haichuan
authors.initials: H
authors.lastname: Hu
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Li
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Ye
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Xiaoyang
authors.initials: X
authors.lastname: Luo
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Yiliang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: 1] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China [2] Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Shen
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Yihua
authors.initials: Y
authors.lastname: Sun
authors.affiliation: 1] Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors.forename: Haiquan
authors.initials: H
authors.lastname: Chen
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D025542:Neurofibromin 1 / Q000235:genetics; D016017:Odds Ratio; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D015996:Survival Rate
chemical_list: D025542:Neurofibromin 1; D047428:Protein Kinase Inhibitors; D066246:ErbB Receptors