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Jianming Ying



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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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      P2.16-49 - Which Nomogram is More Reliable to Predict Recurrence of Pathological Stage IA Lung Adenocarcinoma Treated by Surgery? (ID 13307)

      16:45 - 18:00  |  Author(s): Jianming Ying

      • Abstract
      • Slides

      Background

      Previous recurrence risk models offered individualized prediction using a more diverse set of factors than traditional staging measures American Joint Committee on Cancer Tumor Node Metastasis (AJCC TNM) Staging System. Several studies have demonstrated gene mutation as a new prognostic factor, such as EGFR, KRAS and so on. This study aimed to analyze a comprehensive and reliable Nomogram prognostic model to predict recurrence in stage IA lung adenocarcinoma (ADC) with radical resection.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This was a retrospective, single-center and case-control study. Clinicopathologic, genetic, therapeutic features and survival status were collected. Univariate and multivariate Cox proportional hazards model was conducted. The nomogram for recurrence prediction was developed using Cox proportional hazards regression. Three nomograms were established based on a) AJCC 8th TNM Staging, b) multivariate analysis results and c) risk factors recorded in published references. The higher concordance index (C-index) of model identified better performance of nomogram.

      4c3880bb027f159e801041b1021e88e8 Result

      1499 patients with pathological stage IA ADC from Cancer Hospital, Chinese Academy of Medical Sciences from October 2012 to December 2015 were enrolled in this study. The recurrence rate was 3.5% (53/1499). No recurrence of 180 patients randomly selected and analyzed in this study. Median DFS was not reached. The C-index of AJCC 8th TNM staging and the nomogram based on multivariate analysis was 0.598 (95% CI 0.538-0.659) and 0.696 (95% CI 0.629- 0.764), respectively. The nomogram established on prognostic factors in previous studies, which included gene mutation such as EGFR, KRAS and ALK, showed higher discrimination with C-index 0.833 (95% CI 0.786-0.880).

      8eea62084ca7e541d918e823422bd82e Conclusion

      This was the first individualized nomogram combining clinicopathologic features with genetic information to predict recurrence in ADC. The nomogram added with gene mutation status demonstrated superior predictive capability comparing to other nomograms based on traditional AJCC T staging and multivariate analysis. Our nomogram was more reliable to guide prognostic factors and recurrence rate in stage IA ADC patients.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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