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W. Yang



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    Imaging and locally advanced NSCLC (ID 41)

    • Event: ELCC 2017
    • Type: Poster Discussion session
    • Track:
    • Presentations: 1
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      61PD - Recurrence risk-scoring model for resected stage I lung adenocarcinoma with solid component (ID 326)

      14:45 - 15:45  |  Author(s): W. Yang

      • Abstract

      Background:
      The presence of solid histologic pattern in lung adenocarcinoma (ADC) is associated with early recurrence. However, individualized prognosis in patients with solid component is still unclear. This study aimed to develop a nomogram predicting the recurrence probability in stage I lung ADC patients with solid component.

      Methods:
      A total of 5904 patients with stage I lung ADC who underwent curative surgical resection from January 2008 through December 2014 at Shanghai Chest Hospital were retrospectively reviewed. Tumors were subtyped by using the IASCL/ATS/ERS classification. Of these patients, 708 contained a solid component. Prognostic value of gender, age at diagnosis, smoking history, operation type, tumor location, tumor size, pathological subtype, cell differentiation, lymphovascular and visceral pleural invasion were investigated. Multivariate Cox regression analysis of recurrence-free survival (RFS) in patients with solid component was performed and a nomogram to predict RFS was constructed. The nomogram was internally validated.

      Results:
      The overall recurrence rate in patients with solid component was 25.0% (177/708), with predominant solid subtype and minor solid component in 49.2% (87/177) and 50.8% (90/177) of cases, respectively. Larger tumor size (P = 0.002), predominant solid component (P = 0.003), advanced age at diagnosis (P = 0.015), and visceral pleural invasion (P = 0.040) were associated with an increased risk of recurrence and were included in the nomogram. The predictive model had a concordance index of 0.643 (95% confidence interval, 0.601-0.685) and showed good calibration.

      Conclusions:
      The nomogram model including identified risk factors for RFS is applicable in treatment decision-making for early stage lung ADC with pathological solid component. External validation is required to recommend this nomogram in routine practice.

      Clinical trial identification:


      Legal entity responsible for the study:
      Shanghai Chest Hospital

      Funding:
      Shanghai Chest Hospital

      Disclosure:
      All authors have declared no conflicts of interest.

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    Poster Display Session (ID 63)

    • Event: ELCC 2017
    • Type: Poster Display Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
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      62P - Risk factors associated with early vs late recurrence in stage I lung adenocarcinoma (ID 436)

      12:30 - 13:00  |  Author(s): W. Yang

      • Abstract

      Background:
      Patients with stage I lung adenocarcinoma (ADC) develop recurrences after complete surgical resection, both early and over the long term. This study aimed to identify and compare risk factors for early and late recurrence after surgery in stage I lung ADC patients.

      Methods:
      We analyzed recurrences among 5904 patients with stage I lung ADC who underwent curative operations at Shanghai Chest Hospital between January 1, 2008 and December 31, 2014. Recurrences were classified as within 2 years (early), and more than 2 years (late) after surgery. The clinicopathologic findings were compared between patients with early and late recurrences. Both univariate and multivariate analyses were performed, incorporating factors of gender, age at diagnosis, operation type, tumor location and size, pathologic subtype, cell differentiation, lymphovascular invasion, visceral pleural invasion, and smoking history.

      Results:
      Recurrence occurred in totally 628 (10.6%) patients, with early and late recurrence in 300 and 328 patients, respectively. Early and late recurrences shared common risk factors of advanced age at diagnosis (P = 0.013 and P = 0.006, respectively), poorly cell differentiation (both P = 0.000), larger tumor size (both P = 0.000), and visceral pleural invasion (both P = 0.000). Early recurrence was additionally associated with male (HR, 1.327; 95%CI, 1.042-1.690; P = 0.022), sublobar resection (HR, 2.353; 95%CI, 1.634-3.387; P = 0.000), tumor located in the right middle lobe (HR, 1.711; 95%CI, 1.634-3.387; P = 0.005) and solid, micropapillary or variant subtypes (HR, 5.437; 95%CI, 1.258-23.509; P = 0.023).

      Conclusions:
      These findings suggest the existence of different risk factors accounting for early vs late recurrences among patients with stage I lung ADC.

      Clinical trial identification:


      Legal entity responsible for the study:
      Shanghai Chest Hospital

      Funding:
      Shanghai Chest Hospital

      Disclosure:
      All authors have declared no conflicts of interest.