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K.T. Imai



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    P1.03 - Poster Session with Presenters Present (ID 455)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Radiology/Staging/Screening
    • Presentations: 1
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      P1.03-022 - Possibility of FDG-PET Predicting the Clinicopathological Characteristics and Prognosis of Lung Adenocarcinoma: Multicenter Study (ID 5799)

      14:30 - 15:45  |  Author(s): K.T. Imai

      • Abstract

      Background:
      This multicenter study aimed to investigate the relationship of standardized uptake value (SUV) on [18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) and the clinicopathological characteristics of lung adenocarcinomas, and if it can be a predictor of prognosis of those patients.

      Methods:
      A total of 870 patients of adenocarcinoma patients received FDG-PET preoperatively and underwent curative resection with systematic lymph node dissection. The relationship among histological characteristics, pathological staging, prognosis, and SUV on FDG-PETmax was retrospectively examined.

      Results:
      The pathological stages of the cases were IA 526, IB 182, IIA 62, IIB 27, IIIA 67, IIIB 1, and IV 5, respectively. Pathological N1 (n = 60) and N2 (n = 58) cases showed a significantly higher SUVmax than N0 (n = 752) (9.15 ± 7.13 and 8.58 ± 6.14 vs 3.23 ± 4.16). Cases with pathological tumor invasiveness such as lymphatic, vascular or pleural infiltration showed a significantly higher SUVmax than cases with no invasiveness. (Ly negative; n=687, 2.76±3.59 vs Ly positive; n=183, 7.67±6.23, and v0; n=641, 2.18±2.58 vs v1 or 2; n=229, 8.30±6.23. p<0.001, respectively) The areas under the receiver operating characteristic curve for SUVmax used to predict the relapse-free survival was 2.9 (p < 0.001) in adenocarcinoma. The 3-year relapse-free survival was 97%/66% (SUVmax lower/ higher than 2.9) in adenocarcinoma. SUVmax was parallel to the aggressive nature based on histological subtypes (AIS +MIA; n=76, 0.51±0.58, Lepidic + Papillary + Acinar; n=686, 3.52±4.12, and Solid + Micropapillary; n=84, 8.52±6.67), which was statistically significant. (p<0.001 respectively)

      Conclusion:
      SUVmax of the primary tumor reflected the biological malignancy of lung adenocarcinomas. SUVmax is also useful for predicting pathological stage and prognosis. Multimodality treatment might be recommended in cases of high UVmax.

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    P1.08 - Poster Session with Presenters Present (ID 460)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P1.08-034 - Prognostic Impact of EGFR Mutation in Patients with Surgically Resected Lung Adenocarcinoma; Analysis about Subtypes of EGFR Mutations (ID 6031)

      14:30 - 15:45  |  Author(s): K.T. Imai

      • Abstract

      Background:
      Epidermal growth factor receptor (EGFR) gene mutations have an important role for predicting the prognosis in advanced or recurrent lung cancer patients. However, the significance of EGFR mutation as a prognostic factor for survival after complete resection remains controversial. The aim of this study is to evaluate the impact of mutational status in patients with surgically resected lung adenocarcinoma.

      Methods:
      We retrospectively investigated the data of 414 patients (pts) with p-stage I-IIIA adenocarcinoma who underwent completely tumor resection in our hospital from 2009 to 2013. Overall survival (OS), disease-free survival (DFS) , and clinico-pathological factors affecting these factors were evaluated.

      Results:
      There were 202 males and 212 females (median age, 67 years). In total, 270 (65%), 66 (16%) and 78 pts (19%) had p-stageI, II and IIIA disease respectively. In all 210 pts (51%) with EGFR mutation were detected. Eighty-six pts (21%) had exon 19 deletion (19 del) and 113 pts (27%), exon 21 mutation (L858R). Among 414 pts, 131 pts (31%) had lung cancer recurrence. The median follow-up period was 38.6 months. p-stageI mutant/wild:145/125, II:24/42, and IIIA:41/37. The 3-year survival rates of p-I-II and IIIA mutant/wild were 96.8%/92.1% and 81.6%/61.8% respectively. The median survival time of p-stageIIIA mutant was 80.5 months, and those of others were not reached. The 3-year DFS of p-I-II and IIIA mutant/wild were 78.3%/69.2% and 27.1%/45.1%, respectively. There were no significant difference in OS and DFS at each p-stage despite the EGFR mutational status. Compared to the wild type, the p-IIIA mutant group had a poor DFS. conversely, compared to wild type, the p-I mutant group showed a favorable DFS. According to the subtypes of EGFR mutation, there were no significant differences among EGFR subtypes, but pts with 19del tended to have the worst DFS. In subgroup analysis of 131 pts with recurrence, 3-year survival rate of p-I-II and IIIA mutant/wild were 92.0%/75.8% and 80.8%/45.6% respectively. Pts with p-IIIA mutant showed significantly favorable OS than those of wild type (p=0.014) as well as with p-I-II wild type. Although OS was not significantly different among the subtypes of EGFR mutation, pts with 19del showed statistically better prognosis than shown by the wild type (p=0.038).

      Conclusion:
      EGFR status was an independent prognostic factor in pts with surgically resected lung adenocarcinoma. Particularly, EGFR exon 19 deletion might be the strongest predictive factor of poor DFS and good OS in resected lung adenocarcinoma.