Growth pattern-based grading of pulmonary adenocarcinoma-Analysis of 534 cases with comparison between observers and survival analysis.

•Predominant pattern assigned by 2 independent observer was an exact match in 51.7% of cases.•Predominant pattern determined by both observers showed significant stratification of survival.•All 3 grading schemes showed a significant difference in OS and PFS determined by both observers.•Multivariable and stage I analyses showed pattern-based grading schemes maintained significance.