Author of

• 16751

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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)

  • 16827

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    P1.05-076 - Risk Factors in Patients with Pathological Stage I Non-Small Cell Lung Cancer (ID 4256)

    14:30 - 15:45  |  Author(s): T. Okamoto
    • Abstract

    Background:
    Patients with pathological (p-) stage I non-small cell lung cancer (NSCLC) can have good prognosis with complete resection, whereas some patients die from disease recurrence. The aim of this study was to investigate the risk factors for p-stage I NSCLC.
    
    Methods:
    We retrospectively reviewed 234 patients with completely resected p-stage I NSCLC from March 2005 to December 2015. Patients with synchronous or metachronous multiple lung cancer or malignancies from other organs were excluded. Clinicopathological factors were analyzed, including age, sex, serum carcinoembryonic antigen (CEA) levels, histology, surgical procedure, tumor size, pleural invasion, lymphatic invasion, vascular invasion, and histological grade. Univariate and multivariate analyses of disease-free survival (DFS) and overall survival (OS) were performed.
    
    Results:
    The study group included a total 234 patients, with 119 men and 115 women, ranging in age from 22 to 88 years (mean 68±10.4 years). The median follow-up period was 50.7 months. The preoperative serum CEA level was elevated in 37 patients. Complete resection was performed in all patients, comprising pneumonectomy in one patient, and bilobectomy in two, lobectomy in 192, segmentectomy in 17, and wedge resection in 22. Adenocarcinoma, squamous cell carcinoma, and other histology were observed in 187, 38 and nine patients, respectively. The maximum tumor diameter exceeded 30 mm in 63 patients and tumor diameter was 30 mm or less in 171 patients. There were 38 patients with pleural invasion, 24 patients with lymphatic invasion, and 34 patients with vascular invasion. Multivariate analysis showed that pleural invasion and lymphatic invasion were independent factors for recurrence, whereas older age (>70 years), high serum CEA levels, pleural invasion, lymphatic invasion and vascular invasion were independent factors for poor survival. The 5-year DFS and OS in patients without pleural invasion and without lymphatic invasion were 88.5% and 93.5%, respectively, compared with 29.1% and 33.2% in patients with pleural invasion and with lymphatic invasion (p < 0.001).
    
    Conclusion:
    Pleural invasion and lymphatic invasion were independent factors for recurrence and poor survival in p-stage I NSCLC. Adjuvant chemotherapy should be considered for patients with lymphatic invasion.