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S. Jonsson
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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: 2
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-023 - Primary Adenocarcinoma in the Lung Reclassified - Histological Subtypes and Outcome (ID 2131)
09:30 - 17:00 | Author(s): S. Jonsson
- Abstract
Background:
Non-small cell lung cancer (NSCLC) comprises 85% of primary lung cancer, where adenocarcinoma, squamous cell and large cell carcinoma are the most common histological types. Recently a new classification of primary adenocarcinomas of the lung was published. The aim of this study was to review the histology of all primary lung adenocarcinomas operated on in Iceland during a 20 year period, 1991-2010, using the new criteria and assess the impact of histology on survival.
Methods:
This nationwide study included 301 patients with primary lung adenocarcinoma (mean age 65.5 yrs., 56% female) that underwent resection in Iceland between 1991-2010. Tumors were reclassified according to the current IASLC/ATS/ERS pulmonary adenocarcinoma classification system. Overall survival was estimated by the Kaplan-Meier method and multivariate Cox regression analysis used to evaluate prognostic factors of survival, including histological subtype
Results:
Acinar predominant adenocarcinoma was the most common histological subtype (45%). Solid predominant with mucin production comprised 24% of the cases, lepidic predominant 19% and papillary predominant 8%. There was one in situ adenocarcinoma, three minimally invasive adenocarcinomas and seven invasive mucinous adenocarcinomas. Overall survival at 1 year for all histological subtypes of adenocarcinoma was 81.1% and 42.6% at 5 years. A statistically significant difference in survival between the histological subtypes was not seen (log-rank test, p=0.43). Using multivariate analysis advanced stage and age predicted a worse outcome. Histologic subtyping did neither predict survival in uni- or multivariate analysis.
Conclusion:
Acinar and solid predominant adenocarcinoma are the most common histological subtypes for primary lung adenocarcinoma in Iceland. There was not a statistical difference in survival according to histological subtypes and the subtyping was not a prognostic factor of survival.
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P1.04-073 - The Role of the Stress-Response to a Lung Cancer Diagnosis in Disease Progression (ID 2661)
09:30 - 17:00 | Author(s): S. Jonsson
- Abstract
Background:
Receiving a cancer diagnosis, particularly of lung cancer, has been shown to increase psychological and biological stress responses and the immediate risks of extreme adverse health outcomes, such as suicide and cardiovascular deaths. Data are scarce on the potential influence of this diagnosis on tumor progression. Prior studies lend suggestive evidence for an association of psychobiological stress-responses on lung cancer progression. The aim of this study is to improve understanding of determinants of the stress-response to a lung cancer diagnosis and explore potential role of this response in disease progression and survival.
Methods:
We have initiated a nationwide prospective cohort study of Icelandic lung cancer patients with a comprehensive questionnaire and biomarker measures of stress, as well as detailed documentation of clinical parameters and disease course. Eligible are all individuals diagnosed with lung cancer at Landspitali University Hospital in Iceland. The aim is to recruit 300 patients over a three year period between 2015 and 2017. Patients with clinical or radigraphic changes suggestive of lung cancer are referred to our hospital. They go through a diagnostic work-up, leading to a definite lung cancer diagnosis and staging during a 24 hour diagnostic course or within few days thereafter. Assessment of psychological stress and relevant biomarkers are integrated with clinical assessments at two time points, i.e. during the diagnostic work-up and at follow-up visit 1-3 weeks later (before treatment). The study participation involves questionnaire assessment of symptoms of anxiety, depression, posttraumatic stress, sleep disturbances and quality of life. Biomarker repositories include overnight urine collection, diurnal saliva and hair sampling for analysis of cortisol and catecholamines along with ECG to determine heart rate variability. Bronchoscopic and core needle biopsies as well as surgical tumor samples will be used for assessment of apoptosis, proliferation, microvascular density and adrenoreceptors expression. Radiographic progression will be assessed at baseline and every 6 months from diagnosis along with complete documentation of clinical parameters, disease course and survival.
Results:
In 4 weeks we have recruited 8 patients (80% acceptance rate). We will characterize determinants of a severe psychological-, neuro-endocrine- and cardiovascular stress-response to a cancer diagnosis, as well as the potential relevance of these responses on tumor characteristics, radiographic progression and disease-specific survival. We expect to present preliminary results from approximately 30 patients at the conference.
Conclusion:
Significance: This research program is the first comprehensive attempt to evaluate determinants of psychobiological-induced responses to a lung cancer diagnosis and their potential impact on cancer progression. The findings might guide intervention strategies to improve quality of life, reduce morbidity and prolong survival in lung cancer patients.
