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A. Charpidou



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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
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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): A. Charpidou

      • Abstract
      • Slides

      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
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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): A. Charpidou

      • Abstract
      • Slides

      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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