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H. Kuwano
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-019 - A Comparative Study of Micropapillary Pattern and Computed Tomographic Findings in the Patients with Small Lung Adenocarcinoma (≤ 2cm) (ID 2304)
09:30 - 17:00 | Author(s): H. Kuwano
- Abstract
Background:
We have recently demonstrated that presence of the micropapillary pattern increases the risk of local recurrence after limited resection for ≤2 cm lung adenocarcinoma (ADC). Currently, limited resection for small lung ADC has been done based on the definition of radiological non-invasive lung cancer, until histological subtype have not been examination. The purpose of this study is to investigate whether the presence of micropapillary pattern correlates with radiological non-invasive lung cancer in small lung ADC.
Methods:
All available tumor slides from patients with clinical stage IA, therapy-naive, surgically resected solitary lung ADC ≤2 cm in size (2001-2012) were reviewed. Comprehensive histologic subtyping was performed according to the IASLC/ATS/ERS classification. Tumor diameter and solid component diameter were measured at the maximum cut surface of the tumor using high-resolution CT (HRCT). HRCT findings were classified as three groups as pure ground glass nodule (GGN), part-solid, solid based on the IASLC/ATS/ERS classification. Recurrence-free probability (RFP) was estimated using the Kaplan-Meier method.
Results:
233 patients met inclusion criteria (50% women; median age: 67yrs; 48% never-smokers; median tumor size: 1.2cm; 68 pure GGN/ 76 part-solid/ 89 solid; 157 lobectomy; 43 AIS/ 77 MIA/113 IAD; 13 lymph node metastasis). Presence of the micropapillary pattern (≧5%) (MPP≧5) was identified in 21 cases (9%). MPP≧5 was significantly associated with tumor size, lymph node recurrence, lymphatic invasion, vascular invasion (P = .001, .003, .0017, .014, respectively) and was associated with increased risk of recurrence as compared to MMP<5% (5-year RFP: MIP≧5%:74.3%; MIP<5%:87.6%; P = .046). Twenty-one patients with MPP≧5 included 1 pure GGN / 5 part-solid / 15 solid in HRCT. The patient with pure GGN and MPP≧5 showed recurrence in lymph nodes in 10 months after surgery. In pure GGN group, MPP≧5 was associated with increased risk of recurrence as compared to MMP<5% (P=0.0001).
Conclusion:
The patient with radiological non-invasive lung cancer may be included in micropapillary pattern. It is necessary to consider lung adenocarcinoma histological subtypes for the patient with limited resection.
