Abstract
BackgroundPrimary pulmonary papillary adenocarcinoma (PA) is a specific and rare subtype of invasive pulmonary adenocarcinoma (ADC). The knowledge concerning the clinicopathologic features and prognosis of patients with primary pulmonary PA has not been clarified because of its rarity.MethodsThe clinical data of a total of 3391 patients with primary pulmonary PA were retrospectively analyzed to confirm their clinical characteristics and factors influencing prognosis and were in comparison with 3236 patients with non- PA pulmonary adenocarcinoma. All patients were histologically diagnosed between 1988 and 2015 in The Surveillance Epidemiology and End Results (SEER) database. A nomogram with satisfactory predictive performance was established to visually predict long-term survival of these patients.Results and conclusionCollectively, primary pulmonary PA is a rare pathological cancer and its prognosis is analogous to that of non-PA pulmonary adenocarcinoma. Older age, larger lesions, distant metastases, lymph node invasion, and poor pathological differentiation are correlative with unacceptable prognosis. Surgical intervention is conducive to reaping favorable prognosis. Unfortunately, radiotherapy or chemotherapy results of no significant effects on patient survival. In our study, a nomogram with prognostic function is formulated to confer individual prediction of overall survival (OS).
Highlights
Pulmonary carcinoma has multifarious subtypes based on histological pattern and ranks first in both neoplasm incidence and cancer mortality globally [1]
The majority of cases was graded moderately at pathological differentiation; 40% patients with tumor stage T1; 60.2% patients without distant metastasis (M0), and 44.6% patients without lymph node invasion. 1663 (49% of all 3391) patients were performed by surgery intervention and 1289 (38% of all 3391) patients received lobectomy or bilobectomy
Data analysis shows that patients with radiotherapy or chemotherapy therapy were characterized by larger tumor size, more metastatic lesions with lymph node invasion and advanced tumor stage in comparison to those without radiotherapy or chemotherapy therapy (Supplementary Table S1 and Supplementary Table S2)
Summary
Pulmonary carcinoma has multifarious subtypes based on histological pattern and ranks first in both neoplasm incidence and cancer mortality globally [1]. The investigation progress in recent years in the area of lung adenocarcinoma (ADC) has facilitated the occurrence of the 2015 WHO classification of primary lung adenocarcinomas This WHO classification is dependent on a semi-quantitative evaluation of particular histomorphological growth patterns of invasive adenocarcinoma, with each classified as lepidic, acinar, papillary, micropapillary, or solid predominance. The unique histopathological profile of pulmonary PA is pathologically characterized by the papillary development of cuboidal to columnar cells along with the growth of a fibrovascular core [5]. It primarily exhibits ambiguous pulmonary nodules and is potentially confused with atypical infections [4, 6]. The knowledge concerning the clinicopathologic features and prognosis of patients with primary pulmonary PA has not been clarified because of its rarity
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