Opinions on the reclassification of pulmonary adenocarcinoma <i>in situ</i> in the fifth edition of WHO classification of thoracic tumours_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Rusi ¹ , ZHANG Meifang ² , GAO Shugeng ³ , JIANG Gening ⁴ , WANG Qun ⁵ ,  ZHI Xiuyi ⁶ ,  ZHANG Lanjun ¹

1. Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R.China;
2. Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R.China;
3. Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Cancer Center, Beijing, 100730, P.R.China;
4. Department of Thoracic Surgery, Shanghai Pulmonary Hospital Tongji University, Shanghai, 200433, P.R.China;
5. Department of Thoracic Surgery, Fudan University Affiliated Zhongshan Hospital, Shanghai, 200032, P.R.China;
6. Department of Thoracic Surgery, Xuanwu Hospital of Capital Medical University, Beijing, 100053, P.R.China;

Corresponding author：

ZHI Xiuyi, Email: xiuyizhi2015@163.com; ZHANG Lanjun, Email: zhanglj@sysucc.org.cn

Keywords：

WHO classification of thoracic tumours; adenocarcinoma in situ; lung cancer screening; pulmonary nodule

DOI：

10.7507/1007-4848.202106003

Video：

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Pulmonary adenocarcinoma in situ is reclassified as precursor glandular lesions in the fifth edition of WHO classification of thoracic tumours, causing widespread attention and heated debate among domestic thoracic oncologists, radiologists, pathologists and surgeons. We would like to comment on the topic and make a few suggestions on the management of pulmonary nodule during lung cancer screening. We are open to all suggestion and welcome debates.

Citation： ZHANG Rusi, ZHANG Meifang, GAO Shugeng, JIANG Gening, WANG Qun, ZHI Xiuyi, ZHANG Lanjun. Opinions on the reclassification of pulmonary adenocarcinoma in situ in the fifth edition of WHO classification of thoracic tumours. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(9): 1012-1015. doi: 10.7507/1007-4848.202106003 Copy

1.	Tsao M. PL01.05 The new WHO classification of lung tumors. J Thorac Oncol, 2021, 16(3): S63.
2.	National Lung Screening Trial Research Team, Aberle DR, Adams AM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 2011, 365(5): 395-409.
3.	Li Q, Dai J, Zhang P, et al. Management of pulmonary ground glass nodules: Less is more. Ann Thorac Surg, 2021, S0003-4975(21): 00446-X.
4.	Travis WD, Brambilla E, Noguchi M, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol, 2011, 6(2): 244-285.
5.	Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung tumors: Impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol, 2015, 10(9): 1243-1260.
6.	World Health Organization. (2013). International classification of diseases for oncology (ICD-O) – 3rd edition, 1st revision, 3rd ed. Available at https://apps.who.int/iris/handle/10665/96612. Accessed on 30 May 2021.
7.	Yotsukura M, Asamura H, Motoi N, et al. Long-term prognosis of patients with resected adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung. J Thorac Oncol, 2021, S1556-0864(21): 02124-9.
8.	Lambe G, Durand M, Buckley A, et al. Adenocarcinoma of the lung: From BAC to the future. Insights Imaging, 2020, 11(1): 69.
9.	MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: From the Fleischner Society 2017. Radiology, 2017, 284(1): 228-243.
10.	American College of Radiology. Lung-RADS. Available at https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Lung-Rads. Published 2019. Accessed on June 1, 2019.
11.	Martin MD, Kanne JP, Broderick LS, et al. Lung-RADS: Pushing the Limits. Radiographics, 2017, 37(7): 1975-1993.
12.	National Comprehensive Cancer Network. Lung Cancer Screening (Version 1.2021). https://www.nccn.org/professionals/physician_gls/pdf/lung_screening.pdf. Accessed on June 1, 2021.
13.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
14.	Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
15.	Suzuki K, Watanabe S, Wakabayashi M, et al. A nonrandomized confirmatory phase Ⅲ study of sublobar surgical resection for peripheral ground glass opacity dominant lung cancer defined with thoracic thin-section computed tomography (JCOG0804/WJOG4507L). J Clin Oncol, 2017, 35(15_suppl): 8561.

1. Tsao M. PL01.05 The new WHO classification of lung tumors. J Thorac Oncol, 2021, 16(3): S63.
2. National Lung Screening Trial Research Team, Aberle DR, Adams AM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 2011, 365(5): 395-409.
3. Li Q, Dai J, Zhang P, et al. Management of pulmonary ground glass nodules: Less is more. Ann Thorac Surg, 2021, S0003-4975(21): 00446-X.
4. Travis WD, Brambilla E, Noguchi M, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol, 2011, 6(2): 244-285.
5. Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung tumors: Impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol, 2015, 10(9): 1243-1260.
6. World Health Organization. (2013). International classification of diseases for oncology (ICD-O) – 3rd edition, 1st revision, 3rd ed. Available at https://apps.who.int/iris/handle/10665/96612. Accessed on 30 May 2021.
7. Yotsukura M, Asamura H, Motoi N, et al. Long-term prognosis of patients with resected adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung. J Thorac Oncol, 2021, S1556-0864(21): 02124-9.
8. Lambe G, Durand M, Buckley A, et al. Adenocarcinoma of the lung: From BAC to the future. Insights Imaging, 2020, 11(1): 69.
9. MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: From the Fleischner Society 2017. Radiology, 2017, 284(1): 228-243.
10. American College of Radiology. Lung-RADS. Available at https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Lung-Rads. Published 2019. Accessed on June 1, 2019.
11. Martin MD, Kanne JP, Broderick LS, et al. Lung-RADS: Pushing the Limits. Radiographics, 2017, 37(7): 1975-1993.
12. National Comprehensive Cancer Network. Lung Cancer Screening (Version 1.2021). https://www.nccn.org/professionals/physician_gls/pdf/lung_screening.pdf. Accessed on June 1, 2021.
13. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
14. Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
15. Suzuki K, Watanabe S, Wakabayashi M, et al. A nonrandomized confirmatory phase Ⅲ study of sublobar surgical resection for peripheral ground glass opacity dominant lung cancer defined with thoracic thin-section computed tomography (JCOG0804/WJOG4507L). J Clin Oncol, 2017, 35(15_suppl): 8561.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Opinions on the reclassification of pulmonary adenocarcinoma in situ in the fifth edition of WHO classification of thoracic tumours

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