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D. Grapsa
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-074 - Factors Predicting Discordance between Clinical and Surgical-Pathologic Staging in Operable Non-Small Cell Lung Cancer (ID 4083)
14:30 - 15:45 | Author(s): D. Grapsa
- Abstract
Background:
Accurate clinical staging is of the utmost importance for the optimal management of patients with non-small cell lung cancer (NSCLC). The aim of this study was to identify factors associated with discordance between clinical and pathologic staging in patients with operable NSCLC.
Methods:
The medical records of 85 patients with early-stage NSCLC, who had been submitted to thoracotomy followed by surgical resection of the primary tumor and systematic lymph node dissection, were retrospectively reviewed. All patients were staged according to the 7th edition of the TNM staging system. The presence of postoperative upstaging or downstaging was correlated with various demographic and clinicopathological factors, including age, sex, smoking history, tumor histology, tumor size and location.
Results:
Discordance between clinical and surgical-pathologic staging was found in 45/85 cases (52.9%), and the majority of these patients were upstaged (35/85 cases, 41.2%). Patients with IIB and IB clinical stage had the highest (77.8%) and lowest (48.1%) probability of discordance, respectively. With regard to T stage, disagreement between clinical and surgical-pathologic T stage was noted in 22/85 patients (25.9%), including 16 upstaged patients (16/85, 18.8%) and 6 downstaged patients (6/85, 7.1%). Nodal status was altered postoperatively in 39/85 cases (45.9%), including 29 upstaged patients (29/85, 34.1%) and 10 downstaged patients (10/85, 11.8%). The rate of unsuspected mediastinal lymph node involvement (pathologic stage N2) was 14.1% (12/85 patients), despite negative mediastinoscopy findings. Age was the only statistically significant factor independently associated with staging discordance (odds ratio 0.93; 95% confidence interval, 0.87 to 0.99).
Conclusion:
Postoperative upstaging or downstaging was observed in a relatively high percentage of our patient population, and was significantly and independently correlated with patient’s age. These observations warrant confirmation in larger prospective series of patients with early-stage NSCLC.
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P2.01 - Poster Session with Presenters Present (ID 461)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.01-075 - Prognostic Value of Angiogenesis and Cell Adhesion Biomarkers in Non-small Cell Lung Cancer (ID 4890)
14:30 - 15:45 | Author(s): D. Grapsa
- Abstract
Background:
Previous data on the prognostic value of vascular endothelial growth factor (VEGF), E-cadherin and CD44 in non-small cell lung cancer (NSCLC) remain limited and largely controversial. The primary aim of this study was to further investigate these proteins, along with other well-studied biomarkers of prognosis, as predictors of overall survival (OS) in NSCLC.
Methods:
Formalin-fixed and paraffin-embedded tissue specimens from 77 surgical and 41 autopsy cases, were retrieved and evaluated by immunohistochemistry (IHC) for the expression of VEGF, E-cadherin, CD44, p53, Ki-67 and thyroid transcription factor -1 (TTF-1). Immunohistochemical findings were correlated with gender, age, primary tumor location/side, tumor histology and grade and disease stage at diagnosis. The association of clinicopathologic variables and IHC results with overall survival (OS) was assessed –only in the surgical subgroup- by univariate and multivariate Cox regression analysis.
Results:
Mean age of all cases (N=118) was 64.8 years (SD=11.1 years), while the majority were men (104/118, 88.1%). Adenocarcinoma was the predominant histological type (38.1%), while most cases (62.6%) had stage II disease at diagnosis. E-cadherin and CD44 expression were significantly correlated with lower tumor grade and disease stage at diagnosis, both in the total sample and in the surgical and autopsy subgroups. Positive VEGF expression was also correlated with lower grade and stage, in the total sample and the autopsy subgroup, but not in the surgical subset of cases. Positive E-cadherin and CD44 expression were associated with improved OS, both in univariate analysis (p=0.006 and p=0.011, respectively), as well as in the multivariate model, after adjusting for sex, age, tumor location, histology, grade and stage (HR=0.08, 95% CI: 0.09-0.65, p=0.019 and HR=0.07, 95% CI: 0.09-0.63, p=0.017, respectively).
Conclusion:
Our study findings suggest that positive E-cadherin and CD44 immunostaining may represent independent predictors of an improved survival in NSCLC. Larger prospective studies are nevertheless warranted to confirm the independent prognostic value of these candidate biomarkers.
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P2.03b - Poster Session with Presenters Present (ID 465)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03b-065 - Serum and Bronchoalveolar Lavage Levels of Adiponectin in Advanced Non-Small Cell Lung Cancer: Results of a Prospective Study (ID 4085)
14:30 - 15:45 | Author(s): D. Grapsa
- Abstract
Background:
Adiponectin (APN) is a major adipokine systhesized by the adipose tissue. A significant body of preclinical evidence has documented the involvement of APN in molecular pathways with a key role in carcinogenesis, while some, but not all, previous clinical studies have suggested the potential value of this molecule as a biomarker of diagnosis and/or prognosis in various malignancies, mainly including obesity-related solid tumors. The main objective of this study was to further explore the prognostic implications of APN levels in the serum and bronchoalveolar lavage of patients with advanced non-small cell lung cancer (NSCLC).
Methods:
Twenty-nine (29) consecutive newly diagnosed NSCLC patients with stage IV disease were prospectively enrolled. Serum and BAL levels of APN were obtained at baseline (before initiation of any therapeutic intervention) and assayed by enzyme-linked immunoassay (ELISA). Serum and BAL levels of APN were correlated with standard clinicopathologic parameters, including gender, age, body mass index (BMI), weight loss, size, histology and grade of the primary tumor, pathologic nodal status and performance status (PS). The association of each study variable with overall survival (OS) was assessed by univariate and multivariate Cox regression analyses.
Results:
Mean age of patients was 65.6 years (SD=10.1 years), while the majority were male (24/29 cases, 82.8%). The predominant histological type was adenocarcinoma (18/29 cases, 62.1% ). PS was 0 and ≥1 in 17/29 (58.6%) and 12/29 (41.4%) patients, respectively. Weight loss more than 10% was noted in 10/29 patients (34.5%). Median serum and BAL APN levels were 911.5 ng/ml and 17710 ng/ml, respectively. No statistically significant correlations were observed between the serum or BAL levels of APN and the clinicopathologic parameters evaluated. Univariate Cox regression analysis showed that APN levels were not significantly associated with survival. The only prognostic factor identified, both by univariate and multivariate survival analysis, was PS.
Conclusion:
The results of our prospective cohort failed to reveal any significant associations between serum or BAL levels of APN and several prognostic parameters (including OS) in stage IV NSCLC, thus confirming most previous observations.
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-019 - TTF-1 Expression as a Predictor of Response to EGFR-TKIs in Patients with Lung Adenocarcinoma (ID 4033)
14:30 - 15:45 | Author(s): D. Grapsa
- Abstract
Background:
Several studies have shown that overexpression of thyroid transcription factor (TTF-1) may be associated with the presence of epidermal growth factor receptor (EGFR) gene mutations and predict survival in patients with non-small cell lung cancer (NSCLC). Nevertheless, the potential significance of TTF-1 immunostaining as a predictor of response to EGFR tyrosine kinase inhibitors (TKIs) has received limited research attention thus far. The aim of this study was to further explore the potential association between TTF-1 immunohistochemical expression and response to EGFR TKIs in patients with lung adenocarcinoma.
Methods:
The medical records of 129 patients with stage IV lung adenocarcinoma, treated at the Oncology Unit of “Sotiria” Athens General Hospital between January 2011 and December 2014, were retrospectively reviewed. All patients had received treatment with EGFR TKIs (erlotinib or gefitinib) and had a known TTF-1 immunohistochemical expression status in formalin-fixed, paraffin-embedded tumour tissue. Demographic and clinicopathological features (age, gender, smoking status and performance status), TTF-1 immunohistochemistry and EGFR mutation status results were correlated to each other as well as with the response rate (RR) to EGFR TKIs, using univariate and multivariate regression analysis.
Results:
Median age of our study population was 68 years (range 26-88 years), while the majority were male (79/129 cases, 61.2%). Patients with EGFR mutant tumors had significantly higher response rates to EGFR TKIs compared to patients with wild-type EGFR tumors (p=0.001). TTF-1 positive staining was weakly associated with the presence of EGFR mutations, without reaching the level of statistical significance (p=0.053). Most importantly, TTF-1 positive staining was not significantly correlated with RR to EGFR TKIs, when gender, age, smoking status, EGFR mutation status and PS were included in the multivariate model.
Conclusion:
The present results failed to demonstrate any independent association between TTF-1 overexpression and the RR to EGFR TKIs in patients with advanced-stage lung adenocarcinoma. Prospective data from larger cohorts of patients are needed to clarify the exact predictive value of TTF-1 immunostaining in this setting.
