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K. Fabian
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P1.06 - Poster Session with Presenters Present (ID 458)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.06-012 - Central and Peripheral Lung Adenocarcinomas Exhibit Different Timing and Predilection for Distant Metastasis (ID 5649)
14:30 - 15:45 | Author(s): K. Fabian
- Abstract
Background:
Although distant metastases are major factors for unfavorable prognosis in lung adenocarcinoma (ADC), metastatic patterns have not been widely analyzed in this malignancy.
Methods:
Clinicopathological data of 1126 ADC patients (541 men, 585 women, mean age: 62.1 ± 9.4 years, 32-88 years) were studied retrospectively, focusing on the localization of primary tumor and distant metastases. Metastases diagnosed at the time of primary tumor diagnosis were defined as early metastases. For statistical analyses, Fisher's exact test and a chi-squared independence test were performed.
Results:
At time of diagnosis, 621 patients had stage IV disease. 435 of them had a solitary organ metastasis, mainly in the contralateral lung (n=187), in the brain (n=66), or in the bone (n=59). During the follow up period another 242 patients developed distant metastasis. 39% of all patients had central (i.e. endobronchially visible) tumor. In cases with early-, late-, and non-metastatic disease, the proportions of central tumors were 43%, 35% and 31%, respectively. Central primary tumors were significantly more likely to give rise to early metastases than peripheral ones (p=0.021). When comparing central and peripheral lung cancers according to their metastatic sites, in central tumors lung metastases appeared significantly earlier (p=0.017), while in peripheral ones bone metastases appeared significantly later (p=0.015). There were significant differences in the metastatic organ distributions of central vs. peripheral primary tumors for early (p=0.025) and late (p=0.009) metastases. There was no significant difference in the metastatic organ distributions of right vs. left lung primaries both for early and late metastases. In right lung tumors brain metastases appeared later (p=0.047). No significant difference was observed in the metastatic organ distributions of primary tumors of the upper vs. lower lobes for early (p=0.051), and late (p=0.528) metastases. Early appearance was characteristic for lung, pleural, and adrenal involvement (p<0.001 in all comparisons), while late development was typical for brain metastasis (p=0.002). Bone, liver, subcutaneous, and pericardial metastases showed no such tendencies.
Conclusion:
There are significant differences in metastatic organ distributions of central vs. peripheral lung cancers both for early and late metastases. Central primary tumors are more likely to give rise to early metastases than peripheral ones. Results of molecular subgroup analyses will be presented during the Conference.
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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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P2.01-039 - Prognostic Significance of Claudin Protein Expression in Histological Subtypes of Non-Small Cell Lung Cancer (ID 5947)
14:30 - 15:45 | Author(s): K. Fabian
- Abstract
Background:
We have investigated the correlation between claudin (CLDN) protein expression and clinicopathological parameters as well as survival in histological subtypes of non-small cell lung cancer.
Methods:
137 pathologic stage I primary bronchial cancers including 49 adenocarcinomas of non-lepidic variants (ADC), 46 adenocarcinomas of lepidic variants (L-ADC), and 42 squamous cell carcinomas (SCC) were examined. Immunohistochemistry (IHC) using antibodies against CLDN1,-2,-3,-4,-7 proteins as well as semiquantitative estimation (IHC scores 0-5) were performed on archived surgical resection specimens.
Results:
Claudin IHC scores of L-ADC differed significantly from ADC (CLDN1: p=0.009, CLDN2: p=0.005, CLDN3: p=0.004, CLDN4: p=0.001, CLDN7: p<0.001, respectively) and SCC (CLDN1: p<0.001, CLDN3: p<0.001, CLDN7: p<0.001, respectively). Highly significant CLDN3-CLDN4 parallel expression could be demonstrated in ADC and L-ADC (p<0.001 in both), which was not observed in SCC (p=0.131). ADC and SCC showed no correlation with smoking, whereas in case of L-ADC heavier smoking correlated with higher CLDN3 expression (p=0.020). Regarding claudin expression and survival, in SCC significant correlation could be demonstrated between CLDN1 IHC positivity and better survival (p=0.038). In NSCLC as a whole, high CLDN2 expression proved to be a better prognostic factor when compared with cases where CLDN2 IHC score was 0-1 vs. 2-5 (p=0.009), however, when analyzed separately, none of the histological subgroups showed correlation between CLDN2 expression and overall survival.
Conclusion:
Our results demonstrated significant claudin expression differences not only between the SCC–ADC and SCC–L-ADC but also between the L-ADC and ADC histological subgroups, which strongly underlines that L-ADC represents a distinct entity within the ADC group. CLDN1 overexpression is a good prognostic factor in NSCLC, but only in the SCC subgroup.
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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-005 - Correlation between Primary Tumor Location and Brain Metastasis Development or Peritumoral Brain Edema in Lung Cancer (ID 5913)
14:30 - 15:45 | Author(s): K. Fabian
- Abstract
Background:
In lung cancer overall survival and quality of life are affected adversely by brain metastases, while peritumoral brain edema is responsible for life-threatening complications.
Methods:
The clinicopathological and cerebral radiological data of 575 consecutive lung cancer patients with brain metastases were analyzed retrospectively.
Results:
In squamous cell carcinoma (SCC) and adenocarcinoma (ADC) peritumoral brain edema was more pronounced as compared with small cell lung cancer (SCLC) (p<0.001, p˂0.001, respectively). There was positive correlation between size of metastasis and thickness of peritumoral brain edema (p<0.001). It was thicker in supratentorial tumors (p=0.019), in younger patients (≤50 years) (p=0.042), and in females (p=0.016). The interval time to brain metastasis was shorter in case of central as compared with peripheral lung cancer (5.3 vs. 9.0 months, p=0.035). Early brain metastasis was characteristic for ADCs. A total of 135 patients had brain only metastases (N0 disease) characterized by peripheral lung cancer predominance (p<0.001), and longer time-to-metastasis interval (9.2 vs. 4.4 months, p<0.001). Overall survival was longer in the brain only subgroup than in patients with N1-3 diseases (p˂0.001).
Conclusion:
According to our results, clinicopathological characteristics of lung cancer are related to the development and radiographic features of brain metastases, and these findings might be helpful in selecting patients who could benefit from prophylactic cranial irradiation.
