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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

  • 26770

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    P1.16-60 - A High Risk of Recurrence After the Resection of Lower Lobe Adenocarcinoma (ID 12475)

    16:45 - 18:00  |  Presenting Author(s): Kazuhiro Ueda
    • Abstract
    • Slides

    Background
    

    According to previous reports, non-small cell lung cancers arising in the lower lobe are associated with a worse prognosis than those arising in the upper lobe; however, the reason remains to be elucidated. Thus, we attempted to identify high-risk population in patients with lower lobe disease, that may substantially cause poor prognosis of lower lobe disease.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We retrospectively reviewed a consecutive series of 400 patients with completely resected lung adenocarcinoma who were treated between January 2006 and December 2015. All patients underwent major lung resection and lymph node dissection. The clinicopathological factors that were investigated included the solid component size, the pathological subtype (pre-invasive, minimally invasive/invasive), the epidermal growth factor receptor (EGFR) mutation status, and some other characteristics (TNM 8th edition).

    4c3880bb027f159e801041b1021e88e8 Result
    

    The proportion of never-smokers among patients with lower lobe disease was significantly higher than that among those with upper lobe disease. According to a multivariate proportional hazards analysis, primary site (upper/lower) was an independent predictor of early recurrence, along with the solid component size, pleural lavage cytology results, pathological pleural invasion, and pathological lymph node metastasis. However, although lower lobe disease was associated with early recurrence in never smokers (Fig 1A), it was not in smokers (Fig 1B). Furthermore, although lower lobe disease was associated with early recurrence in never smokers with EGFR wild-type tumors (Fig 1C), it was not in never smokers with EGFR mutant tumors (Fig 1D). EGFR wild-type tumors were more frequently detected in patients with lower lobe disease than in those with upper lobe disease when the analysis was restricted to never smokers.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Patients with lower lobe cancer, particularly those without a smoking history or those with EGFR wild-type tumors, showed a higher risk of recurrence than their counterparts with upper lobe disease. Further studies that include the molecular profiling of such aggressive lesions, are warranted.

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