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Erjia Zhu
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MA09 - Lung Cancer Surgical and Molecular Pathology (ID 908)
- Event: WCLC 2018
- Type: Mini Oral Abstract Session
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 15:15 - 16:45, Room 202 BD
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MA09.02 - Tumor Size and Frozen Section Should Be Considered Jointly to Predict the Final Pathology for Lung Adenocarcinoma (ID 13365)
15:20 - 15:25 | Presenting Author(s): Erjia Zhu
- Abstract
Background
Invasive adenocarcinoma intraoperatively misdiagnosed as adenocarcinoma in situ or minimally invasive adenocarcinoma is more likely to undergo potentially insufficient resection. The purpose of our study was to evaluate the diagnostic accuracy of frozen section.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively reviewed 1,111 lung adenocarcinomas to evaluate the diagnostic performance of frozen section. A derivation cohort consisting of 436 cases of AIS or MIA diagnosed by frozen section in the same period were analyzed to find predictive factors for invasive adenocarcinoma as the final diagnosis. Validation cohorts were included to confirm the results.
4c3880bb027f159e801041b1021e88e8 Result
Intraoperatively measured tumor size was the only independent factor for invasive adenocarcinoma as the final diagnosis (P = 0.001) in the derivation cohort, and was confirmed by validation cohorts. Fifty-nine misdiagnosed invasive adenocarcinomas in the three cohorts consisted of 54 lepidic predominant type, 1 papillary and 4 acinar predominant type. There were no positive N1, N2 node, pleural, lymphatic and vascular invasion cases found. Thirty-seven (37/59, 63%) cases of misdiagnosis were attributed to sampling error, which was the main reason.
8eea62084ca7e541d918e823422bd82e Conclusion
Adenocarcinoma in situ or minimally invasive adenocarcinoma ≥ 1 cm by frozen section were more likely to be invasive adenocarcinoma because of sampling error.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.16-19 - Neither Maximum Tumor Size nor Solid Component Size Was the Best Prognosticator for Subsolid Nodule (ID 13662)
16:45 - 18:00 | Presenting Author(s): Erjia Zhu
- Abstract
Background
Solid component size is used to define the T stage of subsolid nodule in the eighth edition TNM stage classification. Our study aimed to explore whether solid component size was the best parameter for T staging.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively reviewed the clinical data of 431 cTis-T3N0M0 subsolid nodule from Shanghai Pulmonary Hospital. Maximum tumor size, solid component size and tumor size in mediastinal window were carefully recorded. Prognostic ability of different turmor size was compared by time-dependent receiver operating curve.
4c3880bb027f159e801041b1021e88e8 Result
Survival revealed maximum tumor size, solid component size and tumor size in mediastinal window were statistical significant predictors. However, solid component size performed the worst of them, relatively.
8eea62084ca7e541d918e823422bd82e Conclusion
Tumor size remains a common used parameter for nodule evaluation. Solid component size maybe not the best parameter for T staging.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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P2.16-13 - A Proposal of Classification for Subsolid Nodule: Prognostic Impact of T Descriptor (ID 13377)
16:45 - 18:00 | Presenting Author(s): Erjia Zhu
- Abstract
Background
Prognosis of lung cancer presenting as subsolid nodule is satisfying, and prognostic impact of tumor size for subsolid nodules is not so clear as pure-solid nodule. Our study aimed to find whether T staging is suitable for subsolid nodule.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively reviewed 431 cTis-T3N0M0 subsolid nodules in our hospital. Maximum tumor size, solid component size, consolidation/tumor ratio (CTR) were measured.
4c3880bb027f159e801041b1021e88e8 Result
Five year recurrence-free survival (RFS) and overall survival (OS) were 94.2% and 97.0%. Nodules with maximum tumor size < 2 cm & CTR ≤ 0.5, maximum tumor size < 2 cm & CTR > 0.5 and maximum tumor size > 2 cm & CTR ≤ 0.5 were defined as low-risk group. Nodules with maximum tumor size > 2 and CTR > 0.5 were defined as high-risk group. Five year RFS and OS were both 99.0% for low-risk group, 81.0% and 91.4% for high-risk group. Maximum tumor size, solid component size and CTR were not the prognosticator for low-risk nodules but were significant for high-risk nodules.
8eea62084ca7e541d918e823422bd82e Conclusion
We suggest using T descriptor only for clinical high-risk subsolid nodule. Prognosis of low-risk nodules is excellent, no clear relationship with tumor size or CTR.
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