title: Analysis of the clinicopathologic characteristics and prognostic of stage I invasive mucinous adenocarcinoma.
abstract: OBJECTIVE
  The correlations between histological, clinical features and prognosis of stage I invasive mucinous adenocarcinoma (IMA) have not been thoroughly studied for its rare incidence. This study aimed to compare the prognosis among IMA with different percentage of mucinous component and the effect of adjuvant chemotherapy on IMA patients.
  
  
  METHODS
  A total of 145 stage I IMA and 3536 invasive nonmucinous adenocarcinoma patients with R0 resection were included. Based on the percentage of mucinous pattern presented in tumor, IMA were classified into two subgroups: pure mucinous (>90 % invasive mucinous pattern) and mixed mucinous/nonmucinous (≥10 % of each histologic component). Invasive nonmucinous adenocarcinomas were classified into three subgroups: lepidic (LEP), acinar/papillary (ACN/PAP) and solid/micropapillary (SOL/MIP). Disease-free survival (DFS) and overall survival (OS) were assessed and compared among IMA and invasive nonmucinous patients.
  
  
  RESULTS
  For IMA patients, DFS (p = 0.003) was worse for mixed mucinous/nonmucinous compared with pure mucinous subgroup, OS (p = 0.514) was not prognostically different between two groups. There were no significant difference for DFS (p = 0.428) and OS (p = 0.232) between IMA and invasive nonmucinous adenocarcinoma. However, statistical significance were seen for DFS (p < 0.001) and OS (p < 0.001) between 5 major histological subgroups: LEP and pure IMA showed excellent prognosis, mixed mucinous/nonmucinous IMA and SOL/MIP subtypes presented the worst prognosis. No significant survival benefit from adjuvant chemotherapy for IMA patients.
  
  
  CONCLUSIONS
  Mixed mucinous/nonmucinous IMA had a worse DFS compared with pure mucinous. Early stage IMA could not benefit from adjuvant chemotherapy.
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Jizhuang
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Baohui
authors.initials: B
authors.lastname: Han
authors.affiliation: Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Heng
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Fang
authors.affiliation: Department of Shanghai Lung Tumor Clinic Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Luo
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Yunhai
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Tianxiang
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270, Dong-An Road, Shanghai, 200032, People's Republic of China.
authors.forename: Xinghua
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Qingyuan
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Yiyang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Jiajie
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China. hqchen1@yahoo.com.|Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, 270, Dong-An Road, Shanghai, 200032, People's Republic of China. hqchen1@yahoo.com.|Institutes of Biomedical Sciences, Fudan University, Shanghai, People's Republic of China. hqchen1@yahoo.com.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. hqchen1@yahoo.com.
authors.forename: Haiquan
authors.initials: H
authors.lastname: Chen
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000473:pathology*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents
keywords: Adjuvant chemotherapy; Classification; Invasive mucinous adenocarcinoma; NSCLC; Stage I