{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T19:04:58Z","timestamp":1779563098440,"version":"3.53.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hilar fat invasion raises the T category of otherwise pT1 lung carcinomas to pT2a. Pathologists were surveyed to better understand their awareness and interpretation of hilar fat invasion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pathologists interested in pulmonary pathology were invited to participate in an online survey of hilar fat invasion assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 80 respondents, 58% considered hilar fat any fat that is outside the lung but inside the pleural reflection, 32% considered it to be fat inside the pleural reflection near hilar lymph nodes around the main bronchus, and 10% were uncertain or had a different definition. When asked which pT designation is most appropriate for a lobectomy specimen with a pT1-sized invasive carcinoma that directly invades the fat around the lobar bronchus but does not involve the lobar bronchus margin, 69% indicated pT1c, 23% chose pT2a, and 8% were unsure\/other. For a pneumonectomy specimen with a pT1-sized invasive carcinoma that directly invades the fat around both the lobar and main bronchus but does not extend beyond the pleural reflection or involve the main bronchus margin, 48% assigned pT2a, 39% chose pT1c, and 13% were unsure\/other.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a lack of consensus among pathologists as to what constitutes hilar fat invasion, resulting in considerable interobserver variability in pT categorization. Making hilar fat invasion a standard pT designation could improve awareness, and defining the anatomic boundaries of hilar fat could result in greater consistency in assigning a pT category to tumors that extend into fat outside the lung.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajcp\/aqag044","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T11:45:05Z","timestamp":1775821505000},"source":"Crossref","is-referenced-by-count":0,"title":["Hilar fat invasion is a poorly defined and inconsistently interpreted lung carcinoma staging parameter"],"prefix":"10.1093","volume":"165","author":[{"given":"Kelly J","family":"Butnor","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Vermont Medical Center , Burlington, VT,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alayna M","family":"Westcom","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Vermont Medical Center , Burlington, VT,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"2026052314521948100_aqag044-B1","volume-title":"AJCC Cancer Staging Manual","author":"Rami-Porta","year":"2017","edition":"8th ed"},{"key":"2026052314521948100_aqag044-B2","volume-title":"AJCC Cancer Staging Manual","author":"Rami-Porta","year":"2017","edition":"8th ed"},{"key":"2026052314521948100_aqag044-B3","volume-title":"AJCC Cancer Staging System: Lung\u2014Version 9","author":"Asamura","year":"2024"},{"key":"2026052314521948100_aqag044-B4","first-page":"229","volume-title":"TNM Supplement: A Commentary on Uniform Use","author":"Wittekind","year":"2012","edition":"4th"},{"key":"2026052314521948100_aqag044-B5","first-page":"152","volume-title":"IASLC Staging Manual in Thoracic Oncology","author":"Goldstraw","year":"2009"},{"key":"2026052314521948100_aqag044-B6","first-page":"73","volume-title":"IASLC Staging Manual in Thoracic Oncology","author":"Goldstraw","year":"2009"},{"key":"2026052314521948100_aqag044-B7","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1097\/JTO.0b013e3181eba931","article-title":"Tumor invasion of extralobar soft tissue beyond the hilar region does not affect the prognosis of surgically resected lung cancer patients","volume":"5","author":"Otsuka","year":"2010","journal-title":"J Thorac Oncol"},{"key":"2026052314521948100_aqag044-B8","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.lungcan.2010.11.002","article-title":"Significance of microscopic invasion into hilar peribronchovascular soft tissue in resection specimens of primary non-small cell lung cancer","volume":"73","author":"Sakai","year":"2011","journal-title":"Lung Cancer"},{"key":"2026052314521948100_aqag044-B9","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/ejcts\/ezs429","article-title":"Recent advances in our understanding of lung cancer visceral pleural invasion and other forms of minimal invasion: implications for the next TNM classification","volume":"43","author":"Butnor","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026052314521948100_aqag044-B10","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1111\/his.15504","article-title":"Interobserver reproducibility of hilar soft tissue invasion in testicular germ cell tumours among genitourinary pathologists","volume":"87","author":"Wu","year":"2025","journal-title":"Histopathology"},{"key":"2026052314521948100_aqag044-B11","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1309\/08KK8EKLEHJLW0PF","article-title":"Interobserver agreement on what constitutes visceral pleural invasion by non-small cell lung carcinoma: an internet-based assessment of international current practices","volume":"128","author":"Butnor","year":"2007","journal-title":"Am J Clin Pathol"},{"key":"2026052314521948100_aqag044-B12","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1097\/JTO.0b013e31818e0d9f","article-title":"Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7th edition of the TNM classification for lung cancer","volume":"3","author":"Travis","year":"2008","journal-title":"J Thorac Oncol"}],"container-title":["American Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/165\/5\/aqag044\/68374751\/aqag044.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/165\/5\/aqag044\/68374751\/aqag044.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T18:52:22Z","timestamp":1779562342000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajcp\/article\/doi\/10.1093\/ajcp\/aqag044\/8691531"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ajcp\/aqag044","relation":{},"ISSN":["0002-9173","1943-7722"],"issn-type":[{"value":"0002-9173","type":"print"},{"value":"1943-7722","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,5]]},"article-number":"aqag044"}}