Author of

• 25913

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  MA22 - New Therapeutics, Pathology, and Brain Metastases for Small Cell and Neuroendocrine Tumour (ID 925)

  • Event: WCLC 2018
  • Type: Mini Oral Abstract Session
  • Track: Small Cell Lung Cancer/NET
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 15:15 - 16:45, Room 206 BD

  • 26151

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    MA22.05 - Impact of Tumor Spread Through Air Spaces (STAS) in Lung Neuroendocrine Tumors (NETs) (ID 14221)

    15:45 - 15:50  |  Author(s): Kyuichi Kadota
    • Abstract
    • Presentation
    • Slides

    Background
    

    We have previously reported the prognostic significance of STAS in lung adenocarcinoma and squamous cell carcinoma. The aim of this study was to investigate the incidence and prognostic impact of STAS in lung NETs.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We evaluated all tumor slides (range 2-7, median 3) for presence of STAS from patients with p-Stage I-III primary lung NETs [n=628, typical carcinoid (TC, n=305), atypical carcinoid (AC, n=38), large cell neuroendocrine carcinoma (LCNEC, n=93) and small cell lung carcinoma (SCLC, n=57)]. Patients with combined NETs were excluded from this analysis (n=19). Cumulative incidence of recurrence (CIR) and lung cancer-specific cumulative incidence of death (LC-CID) were analyzed by competing risks approach.

    4c3880bb027f159e801041b1021e88e8 Result
    

    STAS was identified in 25% of NETs (15% in TC, 37% in AC, 43% in LCNEC, and 46% in SCLC). Prognostic analysis in TC cohort was not conducted due to the small number of events (<5 events). Patients with STAS positive tumors were associated with higher CIR than STAS negative tumors in the total (AC-LCNEC-SCLC) cohort as well as individual AC, LCNEC and SCLC cohorts (Figure 1, A-D). STAS was also associated with higher LC-CID in all cohorts except for AC (Figure 1, E-H). In multivariable analysis, STAS was a significant risk factor for recurrence and lung cancer specific-death, independent of stage and histologic subtype. Stratified by stage, STAS was an independent predictor of recurrence (subhazard ratio [SHR] 2.39, 95% CI 1.26-4.54, p= 0.007) and lung cancer-specific death (SHR 2.42, 95% CI 1.21- 4.84, p= 0.012) in LCNEC. In SCLC, STAS was also an independent risk factor of lung cancer-specific death (SHR 4.06, 95% CI 1.33- 12.35, p= 0.014).

    

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    STAS is a significant prognosticator in individual NET subtypes; AC, LCNEC, and SCLC. STAS is an independent poor prognostic factor in LCNEC and SCLC for lung cancer-specific death.

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