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4 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Adenocarcinoma in situ and minimally invasive adenocarcinoma are the earliest forms of lung cancer of the adenocarcinoma type: small tumours, usually seen as ground-glass spots on a CT scan, that have not yet invaded, or have invaded less than five millimetres. When removed they are effectively cured, with no recurrences in the large series, so the question is how little surgery is enough.
The IASLC/ATS/ERS classification introduced adenocarcinoma in situ (a solitary adenocarcinoma of 3 cm or less with pure lepidic growth along intact alveolar walls) and minimally invasive adenocarcinoma (the same with an invasive component of 5 mm or less) in place of the term bronchioloalveolar carcinoma, and the WHO classifications of 2015 and 2021 keep both entities and stage them by invasive size only (Travis 2011; Nicholson 2022). They present as ground-glass or part-solid nodules on CT.
How it differs from its parent: outcome. In 1,038 stage I adenocarcinomas, none of the 36 patients with adenocarcinoma in situ or minimally invasive adenocarcinoma recurred, lepidic predominant invasive tumours had a five-year cumulative recurrence of 8 percent, and non-lepidic tumours 19 percent (Kadota 2014). In 524 resected cases in Japan (65 percent women, 64 percent never-smokers, mean tumour diameter 15.2 mm, 44 percent treated by sublobar resection) there was no recurrence over a median follow-up of 100 months, and the clinical problem was second primary lung cancers rather than relapse (Yotsukura 2021).
| Setting | Approach | Guideline |
|---|---|---|
| All cases | Surgical resection, sublobar where the tumour is small and peripheral, with no adjuvant therapy; the parent's resectable page holds the sublobar-surgery trials. | not mapped |