Lung Adenocarcinoma: Current Trends in a Multidisciplinary Perspective

Dear Colleagues,

Lung adenocarcinoma (ADC) is the most common histotype among the lung tumours. It falls under the category of non-small cell lung cancer (NSCLC) and this kind of lung cancer represents nearly 40 percent of all NSCLCs. A pathologic progression from adenocarcinoma in situ (AIS) to minimally invasive adenocarcinoma (MIA) and finally invasive adenocarcinoma has been described, and among the invasive adenocarcinomas, a heterogenous combination of subtypes has been reported. In fact, it is important to note that pure adenocarcinomas (ADCs), composed of a single subtype, are relatively infrequent, since the majority are composed of at least two patterns mixed together. In this regard, five main subtypes of invasive adenocarcinomas based on the cell pattern that is most predominant are usually reported. These subtypes are:

• Lepidic;
• Acinar;
• Papillary;
• Micropapillary;
• Solid.

In addition to this, according to these clinical peculiarities, the main patterns can be divided into the following groups: the low-grade group (G1), which accounts for lepidic patterns, the intermediate grade group (G2), which accounts for the acinar and papillary pattern, and the high-grade group (G3), which involves solid and micropapillary patterns. Cell pattern identifying subtypes are associated with prognosis, ranging from favorable (lepidic) to intermediate (acinar and papillary) to poor (micropapillary and solid).

Diagnosis and clinical staging are usually made using computed tomography (CT) scanning and fluorodeoxyglucose (FDG)–positron emission tomography (PET), and a biopsy is required to confirm the diagnosis. Therapeutic management varies from surgery for resectable early-stage ADC to radiotherapy or systemic treatments (chemotherapy, targeted therapy, immunotherapy) for patients unfit for surgery and/or metastatic disease. Combined treatments are usually considered.

This Special Issue aims to cover the advances in the diagnosis and management of lung adenocarcinoma, underlining how the multidisciplinary approach is the appropriate way to provide the best outcome.

Dr. Luigi Ventura
Guest Editor

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