Author of

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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

  • 27256

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    P2.16-01 - Prognostic Significance of Preoperative Consolidation to Maximum Tumor Diameter Ratio and Suv-Max in Pathological Stage I Lung Adenocarcinoma (ID 14027)

    16:45 - 18:00  |  Author(s): Özlem Özmen
    • Abstract
    • Slides

    Background
    

    Findings on computed tomography like tumor size, amount of consolidation and ground glass opacity, size of the solid component, maximum standardized uptake value by 18F-fluorodeoxyglucose positron emission tomography/CT and the ratio of the size of solid attenuation to the maximum tumor dimension (consolidation/ tumor [C/T] ratio) are predictive for pathologic subtypes and prognosis after resection.

    There are many number of study about clinical early stage lung cancer in terms of C/T ratio. We aimed to investigate prognostic value of C/T ratio and SUVmax among patients with pathological stage I lung adenocarcinoma

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    258 patients were reviewed by using institution's records who had undergone surgery for early stage lung adenocarcinoma. Only patients with pathological stage I (T1a, T1b and T2a without lymph node metastasis) were included. Synchronous tumor, oligometastatic disease and history of other organ malignancy was exclusion criteria. Seventh TNM edition was used. Totally 168 patients’ demographic data, surgery types, clinical and pathological stage, pre-operative SUVmax and C/T ratio was recorded. Differences between patients with recurrence after surgery and without recurrence was demonstrated. Survival rates were analysed by divided into 3 groups according to C/T ratio (0.25-0.5, 0.5-0.75, 0.75-1.0) and cut-off value 50% of C/T ratio.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Two groups (C/T<0.5 and C/T=0.5-1) did not differ according to comparable factors like visceral pleural invasion, subtype of adenocarcinoma, median SUVmax. Median follow up time was 35 months. 54 patients were died of whom 8 (68%) patients were in C/T ratio<0.5 and 46 patients (67.8%) were in C/T=0.5-1 group. OS was 44.9±5.07 and PFS was 50.8±5.42 in C/T<0.5 group. OS was 69.7±3.34 and PFS was 77.2±3.23 in C/T=0.5-1 group (p>0.05). Three-year survival rate was 50% for C/T <0.5 and 72% for C/T=0.5-1 group (p>0.05). Mean SUVmax is 8.05±6.04 for C/T<0.5 and 10.07±6.85 for C/T≥50% (p= 0.43). Existence of visceral pleura invasion was higher in patients with C/T≥50% (69 patients vs 6 patients, p=0.05). In univariate analyses age, gender and SUVmax value and in multivariate analyses only surgery type and SUV max value were predictors for OS (Surgery type: HR:1.33 (1.04-1.70), p=0.02 and SUVmax: HR:1.04(1.00-1.08), p=0.04).For PFS, only surgery type had significance both unıvariate and multivariate analyses (Univariate: HR: 1.47 (1.15-1.89), p=0.002 and multivariate: HR: 1.67 (1.25-2.23), p=<0.001).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    In pathological stage 1 lung adenocarcinomas, SUVmax and surgery type are important predictors for OS. For PFS only surgery type has significance. Even visceral pleura invasion rates are higher in C/T≥0.5 group, SUVmax is superior to the C/T ratio for predicting prognosis particularly for solid type lung cancer.

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