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J. Nakajima
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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): J. Nakajima
- 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.
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-002 - Impact of Multiple Cancer Treatment History on Outcome in Patients with Surgically Resected Non-Small Cell Lung Cancer (ID 841)
09:30 - 17:00 | Author(s): J. Nakajima
- Abstract
Background:
It has been common that patients with previous cancer treatment history undergo curative resection of non-small cell lung cancer (NSCLC); however, the impact of multiple cancer history on outcome after surgery remains unclear.
Methods:
We conducted a retrospective study by using data from patients who underwent curative surgical resection for NSCLC between 1998 and 2011 at our institution. Data recorded for analyses were: age, gender, clinical and pathological stages of NSCLC, mode of surgical resection, comorbidities, pre-treatment serum CEA level, smoking history, and previous cancer history (organ, histologic type, number of cancer treated). The chi-square test and Wilcoxon test were used to analyze the factors between groups (ie, cases with previous cancer history versus those without cancer history). The Kaplan-Meier method was used to estimate survival rates. The log-rank test was applied to compare the survival rates between the groups. A p value less than 0.05 was considered as statistically significant.
Results:
In the study, 229 out of 923 cases (24.8%) had previous cancer treatment history. In the 229 cases, 194 had single cancer treatment history, 30 had double cancer treatment history, and 5 had triple cancer treatment history. Types of cancer treated were: colorectal cancer (n=51), lung cancer (n=30), hepatocellular carcinoma (n=25), breast cancer (n=16), esophageal cancer (n=15), renal cell cancer (n=12), cancers of head and neck (n=11), and others (n=56). There were significantly increased rate of having cancer treatment history in the later study period (2005-2011) compared to a rate in the earlier study period (1998-2004)(30% versus 15%, p<0.01). When comparing to patients without previous cancer history, those with previous cancer history were significantly older (69.1 versus 66.4 years, p<0.01), and had higher smoking history rate (75.1% versus 64.7%, p<0.01). On the other hand, the proportion of stage I NSCLC was significantly higher in cases with previous cancer history than those without previous cancer history (95.2% versus 74.4%, p<0.01). All cases with triple cancer treatment history had clinical and pathological stage I NSCLCs. The survival outcome after surgical resection was significantly better in cases without previous cancer treatment history than those with cancer treatment history (5-year survival rates; 79% versus 75%). In those with cancer treatment history, cases with 2 or more cancers treated had worse outcome than those with only one cancer treated before lung cancer resection (5-year survival rates; 69% versus 76%).
Conclusion:
Although the previous cancer treatment history and the number of cancers treated affected the outcome of patients who underwent curative lung cancer resection, the 5-year survival rate of 75% was achieved in the population. In those with previous cancer history, lung cancer tends to be found in early stage because of the periodical check-up for previous cancers. Therefore, surgical resection of newly detected NSCLC can be a viable option, if the previously treated cancer(s) are well controlled and the new lung cancer is deemed resectable.
