{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T22:05:18Z","timestamp":1774389918174,"version":"3.50.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>Lung cancer screening has improved mortality among high-risk smokers but has coincidentally detected a fraction of nonprogressive adenocarcinoma historically classified as bronchoalveolar carcinoma (BAC). In the National Lung Screening Trial (NLST) the majority of BAC\u2014comprising 29% of computed tomography\u2013detected stage I lung adenocarcinoma\u2014were considered overdiagnosis after extended follow-up comparison with the control arm. In the current classification, adenocarcinoma in situ and minimally invasive adenocarcinoma have replaced BAC but together comprise only \u223c5% of stage I lung adenocarcinoma. Lepidic and subsets of papillary and acinar adenocarcinoma also infrequently recur. We, therefore, propose criteria for low malignant potential (LMP) adenocarcinoma among nonmucinous adenocarcinoma measuring \u22643\u2009cm in total, exhibiting \u226515% lepidic growth, and lacking nonpredominant high-grade patterns (\u226510% cribriform, \u22655% micropapillary, \u22655% solid), &gt;1 mitosis per 2\u2009mm<jats:sup>2<\/jats:sup>, angiolymphatic or visceral pleural invasion, spread through air spaces or necrosis. We tested these criteria in a multi-institutional cohort of 328 invasive stage I (eighth edition) and in situ adenocarcinomas and observed 16% LMP and 7% adenocarcinoma in situ\/minimally invasive adenocarcinoma which together (23%) approximated the frequency of overdiagnosed stage I BAC in the NLST. The LMP group had 100% disease-specific survival. The proposed LMP criteria, incorporating multiple histologic parameters, may be a clinically useful \u201clow-grade\u201d prognostic group. Validation of these criteria in additional retrospective cohorts and prospective screen-detected cohorts should be considered.<\/jats:p>","DOI":"10.1097\/pas.0000000000001618","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T18:17:14Z","timestamp":1605118634000},"page":"567-576","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":20,"title":["Pulmonary Adenocarcinomas of Low Malignant Potential"],"prefix":"10.1097","volume":"45","author":[{"given":"Ilyas","family":"Yambayev","sequence":"first","affiliation":[{"name":"Pathology & Laboratory Medicine"}]},{"given":"Travis B.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory"}]},{"given":"Kei","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Surgery, Boston University School of Medicine, Boston Medical Center, Boston"}]},{"given":"Qing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Pathology & Laboratory Medicine"}]},{"given":"Sara E.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Pathology & Laboratory Medicine"}]},{"given":"Osman H.","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Pathology & Laboratory Medicine"}]},{"given":"Virginia R.","family":"Litle","sequence":"additional","affiliation":[{"name":"Surgery, Boston University School of Medicine, Boston Medical Center, Boston"}]},{"given":"Paulo","family":"Moreira","sequence":"additional","affiliation":[{"name":"Surgery, Boston University School of Medicine, Boston Medical Center, Boston"}]},{"given":"Elliot L.","family":"Servais","sequence":"additional","affiliation":[{"name":"Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA"}]},{"given":"Cameron T.","family":"Stock","sequence":"additional","affiliation":[{"name":"Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA"}]},{"given":"Syed M.","family":"Quadri","sequence":"additional","affiliation":[{"name":"Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA"}]},{"given":"Christina","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA"}]},{"given":"Kimberly M.","family":"Rieger-Christ","sequence":"additional","affiliation":[{"name":"Department of Translational Research, Ian C. 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