Virtual Library

Start Your Search

F. Lococo



Author of

  • +

    MA10 - Facing the Real World: New Staging System and Response Evaluation in Immunotherapy (ID 393)

    • Event: WCLC 2016
    • Type: Mini Oral Session
    • Track: Radiology/Staging/Screening
    • Presentations: 1
    • +

      MA10.07 - 18F-Fluorodeoxyglucose Positron Emission Tomography Scan in Solid-Type Stage-I Pulmonary Adenocarcinomas: What Cause False-Negative Cases? (ID 4018)

      14:20 - 15:50  |  Author(s): F. Lococo

      • Abstract
      • Presentation
      • Slides

      Background:
      False-negative 18F-fluorodeoxyglucose (FDG) uptake can be divided into those cases related to technological limitations of positron-emission tomography (PET) and others related to inherent properties of neoplasms. We aim to clarify possible factors causing false-negative (FN) PET results in solid-type pulmonary adenocarcinomas (PAs).

      Methods:
      From 01/2007 to 12/2014, among 255 Stage-I NSCLCs we retrospectively review PET/CT-records, clinical information, preoperative thin-section CT-images, and pathological features (classified by the IASLC/ATS/ERS subtyping criteria) of 94 consecutive solid-type Stage-I PA undergone surgical resection at Our Institution. Univariate and multivariate logistic analysis were used to identify and weigh the independent predictors of PET-findings: body weight, blood glucose level, tumor-size, and histological classification.

      Results:
      There were 58 males and 36 females (mean age= 68.7 yrs, range 42-85). Seventeen lesions (18.1%) were judged as PET-negative and 77 lesions (81.9%) as PET-positive. Overall, mean SUVmax was 8.0 (range 0-35) with higher SUVmax-values (p<0.001) in PA>2cm (mean SUVmax=10.6) than PA<2cm (mean SUVmax=4.8). PET false-negative (FN) results were also differently distributed (27.9% in PA <2cm vs 9.8% in PA>2 cm, p=0.023). When clustering the PA in 2 histological classes (Class-A [“colloid/mucinous/lepidic”] vs Class-B [“micropapillary/solid/acinar/papillary”]), the radiometabolic patterns were significantly different [mean SUVmax 3.8 in Class-A vs 9.9 in Class-B, p<0.001], as reported in Figure 1. Similarly, a different distribution of PET FN-cases was observed (38.7% FN in Class-A vs 7.9% FN in Class-B, p=0.001). Table 1 shows the results of multivariate logistic analysis. Both the tumor-size (cut-off=2cm) and IASLC/ATS/ERS aggregated clusters were clinically relevant factors for determining whether PET results were negative or positive, but only histology was statistically significant (OR:6.1, 95%CI: 1.85-20.15, p=0.003). Figure 1



      Conclusion:
      Among solid-type lung adenocarcinoma, tumor-size and histopathological findings were significantly associated with FDG-uptake. In particular, it warrants attention that lesions ≤2cm and “colloid/mucinous/lepidic” adenocarcinomas have a tendency for negative PET-findings.

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    P1.05 - Poster Session with Presenters Present (ID 457)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
    • +

      P1.05-050 - External Validation of a Prognostic Model for Squamous-Cell Lung Cancer and Impact of Adjuvant Treatment in >1,300 Patients (ID 5297)

      14:30 - 15:45  |  Author(s): F. Lococo

      • Abstract
      • Slides

      Background:
      A risk classification model able to powerfully discriminate the prognosis of resected squamous-cell lung cancer (R-SqCLC) patients (pts) was developed (Pilotto JTO 2015). Herein, we validate the model in a larger multicenter series of >1,300 R-SqCLC pts (AIRC project 14282).

      Methods:
      R-SqCLC pts in 6 different institutions (01/2002 - 12/2012) were considered eligible. Each patient was assigned with a prognostic score to identify the individual risk of recurrence, on the basis of the clinico-pathological data according to the develop model (age, T-descriptor according to TNM 7th edition, nodes, and grading). Kaplan-Meier analysis for disease-free/cancer-specific/overall survival (DFS/CSS/OS) was performed according to the published 3-class risk model (Low: score 0-2; Intermediate: score 3-4; High: score 5-6). Harrell’s C-statistics was adopted for model validation. The effect of adjuvant chemotherapy (ACT) was adjusted with the Propensity Score (PS).

      Results:
      Data from 1,375 pts from 6 institutions were gathered (median age: 68 years; male/female: 86.8%/13.2%; T-descriptor 1–2/3–4: 73.3%/26.7%; nodes 0/>0: 53.4%/46.6%; stages I-II/III-IV: 71.7%/28.3%); 384 pts (34.5%) underwent ACT. With a median follow-up of 55 months (95% CI 51-59), pts at Low-Risk had a significantly longer DFS in comparison with Intermediate- (HR 1.67, 95% CI 1.40-2.01) and High-Risk (HR 2.46, 95% CI 1.90-3.19) pts, as well as for CSS (HR 1.79, 95% CI 1.48-2.17; HR 2.33, 95% CI 1.76-3.07) and OS (HR 2.46, 95% CI 1.80-3.36; HR 4.30, 95% CI 2.92-6.33). C-statistics was 68.3 (95% CI 63.5-73.1), 68.0 (95% CI 63.2-72.9), and 66.0 (95% CI 61.6-71.1), for DFS, CSS and OS, respectively. 60-months DFS for Low-, Intermediate- and High-Risk pts was 51.0%, 33.5% and 25.8%, respectively (p<0.0001). 60-months CSS for Low-, Intermediate- and High-Risk pts was 82.7%, 64.7% and 53.3%, respectively (p<0.0001). 60-months OS for Low-, Intermediate- and High-Risk pts was 56.7%, 37.9% and 30.9%, respectively (p<0.0001). A significant benefit in DFS was found in favor of ACT (p=0.005), with no difference in CSS (p=0.57), although a trend in OS (p=0.16). Overall, no significant differences for ACT were found in DFS, CSS and OS when survival was corrected with PS analysis, although CSS and OS curves visually separate with a trend for ACT in Intermediate- and High-Risk pts.

      Conclusion:
      The prognostic performance of the previously developed model was validated in a larger R-SqCLC pts’ series. Considering the overall dismal prognosis of such disease, the efficacy of ACT requires to be clearly established for Intermediate- and High-Risk pts, as well as that should be questioned for Low-Risk pts.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.