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W. Hsu
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P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.02-009 - Prognostic Value of New IASLC/ATS/RES Lung Adenocarcinoma Classification on Dominate Tumor in Synchronous Multiple Primary Adenocarcinomas (ID 447)
09:30 - 17:00 | Author(s): W. Hsu
- Abstract
Background:
The prognostic roles of the dominate tumor and tumor combination pattern in synchronous multiple primary adenocarcinoma (SMPADCs) remain unclear.
Methods:
The predominant histologic pattern of each tumor among SMPADCs was determined according to the new IASLC/ATS/ERS classification system. For recurrence analysis, each tumor was further divided into low, intermediate and high grade prognostic group. The dominate tumor (DT) was representative of the highest prognostic grade in each SMPADCs.
Results:
From 2004 to 2012, there were 108 consecutive nodal-negative patients who underwent surgery for SMPADCs in a tertiary referral center. The median follow-up time was 52.4 months. During follow-up, 38 (35.2%) patients developed recurrence. The pattern of recurrence included local recurrence only in 8 patients (21.1%), distal metastasis only in 11 (28.9%), and both local recurrence and distal metastasis in 19 (50.0%). In multivariate analysis, the percentage of recurrence was significantly higher in older age (p=0.002; odds ratio 6.324) and DT presented with radiologic solid-appearance (vs. pure- , Mixed-GGNs, p=0.032; odds ratio 7.041). In addition, there was no tumor recurrence identified in 17 DTs presented with radiologic pure GGN and 6 DTs in low grade prognostic group. The 5-year overall and disease-free survival of SMPADCs determined by DT in low, intermittent and high grade were 100%, 84.6%, 32.5% (p<0.001) and 100%, 73.9%, 23.3%, respectively (p<0.001). Compared to low/intermediate grade, DT in high grade had significantly worse overall survival (p=0.007; hazard ratio 4.313) and disease-free survival (p=0.045; hazard ratio 2.360) in multivariate analysis. For further combination pattern analysis, high grade DT combined with high grade 2[nd] dominate tumor had significantly worse disease-free survival than that combined with intermediate and low grade 2[nd] dominate tumors.
Conclusion:
DT analyzed with prognostic grouping of the IASLC/ATS/RES histological classification was an independent risk factor regarding to overall and disease-free survivals in complete resected nodal-negative SMPADCs. Figure 1Risks analysis of disease-free survival Variables HR p value HR p value Age 3.212 0.001 2.228 0.026 Gender 1.552 0.182 -- -- Smoking Hx 1.443 0.270 -- -- Preop CEA 1.640 0.217 -- -- Tumor size 2.108 0.024 0.967 0.927 Radiologic appearance 10.814 0.001 3.911 0.086 Pleural invasion 2.069 0.050 0.930 0.869 TNM stage 3.405 0.021 1.334 0.669 Histologic differentiation 4.170 <0.001 1.840 0.118 Angiolymphatic invasion 4.089 <0.001 1.773 0.175 Subtyping predominate 5.399 <0.001 2.360 0.045 Tumor distribution 0.523 0.146 -- -- Same lobe 1.269 0.481 -- -- Adjuvant chemotherapy 1.855 0.072 1.391 0.360 Similar CHS 1.251 0.521 -- --
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P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.03-027 - Factors Predicting Lymph Node Metastasis in Resected Lung Adenocarcinoma of 2cm or Smaller (ID 840)
09:30 - 17:00 | Author(s): W. Hsu
- Abstract
Background:
The predictive value of the new International Association for the Study of Lung Cancer, American Thoracic Society and European Respiratory Society (IASLC/ATS/ERS) classification of lung adenocarcinoma predicting lymph node metastasis in lung adenocarcinoma has not been well demonstrated. The aim of the study is to demonstrate factors associated with lymph node metastasis in patients with resected lung adenocarcinoma of 2 cm or smaller.
Methods:
The clinicopathological characteristics of 246 patients with completely resected lung adenocarcinoma of 2cm or smaller at Taipei Veterans General Hospital between 2004 and 2012 were retrospectively reviewed. The association between clinicopathological variables and lymph node metastasis was analyzed by univariate and multivariate logistic regression.
Results:
Among the 246 patients, there were 215 (87.4%) patients with N0 status, 13 (5.3%) with N1 status, and 18 (7.3%) with N2 status. Greater tumor size (P < 0.001) and predominant pattern group (micropapillary/solid predominant) (P = 0.001) were significantly associated with higher percentage of N1 or N2 lymph node metastasis. In multivariate analysis, greater tumor size (P < 0.001), and micropapillary/solid predominant pattern (P = 0.029) were significant predictors of N1 or N2 lymph node metastasis in tumors of 2cm or smaller. Micropapillary/solid predominant pattern (P = 0.031) was also a significant predictor of N2 lymph node metastasis in multivariate analysis.
Conclusion:
Tumor size and histological subtypes were significantly associated with lymph node metastasis in lung adenocarcinoma of 2cm or smaller. Micropapillary/solid predominant pattern is a significant predictor of lymph node metastasis.
