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  P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

  • 27743

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    P3.16-04 - Comparison of 2D and 3D Consolidation to Tumor Ratios to Predict Less Invasive Lung Adenocarcinoma (ID 11177)

    12:00 - 13:30  |  Presenting Author(s): Toshihiro Ikeda
    • Abstract
    • Slides

    Background
    

    Increases in lung cancer screening with computed tomography have led to more frequent detection of lesions like early stage lung adenocarcinomas. Patients with a ground-glass nodules(GGN) dominant small lesion have an excellent prognosis after complete resection. The consolidation to tumor diameter ratio(d-CTR) is a widely utilized 2D radiological parameter, and lesions with d-CTR<0.5 are candidates for segmentectomy instead of lobectomy. However, the radiological and pathological features of an adenocarcinoma can be contradictory. Some lesions diagnosed as a pure GGN may actually be invasive adenocarcinomas.

    The purpose of this study was to compare 2D and 3D parameters of lesions to identify less invasive pathological Stage I adenocarcinoma.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We retrospectively evaluated 42 lesions from 41 patients who underwent curative resection for pathological Stage I adenocarcinoma from May 2016 to December 2017 at Sakaide citizen hospital. We defined Adenocarcinoma in situ and minimally invasive adenocarcinoma as less invasive histological subtypes. Besides, we defined lesions exhibiting lymphatic or vascular invasion as invasive lesions. The 2D parameter was the d-CTR. The 3D parameter was the volume ratio of the solid part to the whole tumor(v-CTR). We used a cut-off value of 0.5 for the 2D parameter, and then cubed that value to obtain a cut-off of 0.125 for the 3D parameter.

    4c3880bb027f159e801041b1021e88e8 Result
    

    There were 29(69.1%) invasive histological subtypes lesions, 8(19.0%) lymphatic invasion lesions and 11(26.2%) vascular invasion lesions. There were 20(47.6%) lesions d-CTR<0.5, and 12(28.6%) lesions v-CTR<0.125. The 20 lesions with d-CTR<0.5, compared to the 22 with d-CTR>0.5, were significantly more likely to be less invasive histological subtypes(p<0.0001), exhibit no lymphatic invasion(p=0.0009), or exhibit no vascular invasion(p=0.0005). In multivariate analysis, having a d-CTR<0.5 was a significant predictive factor for less invasive lesions. Similarly, the 12 lesions with v-CTR<0.125, compared to the 30 with v-CTR>0.125, were more likely to be less invasive histological subtypes(p<0.0001), exhibit no lymphatic invasion(p<0.0001), or exhibit no vascular invasion(p=0.0014). However, the 8 lesions with v-CTR>0.125, despite having d-CTR<0.5, all had invasive histological subtypes(p=0.0009).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    The values d-CTR<0.5 and v-CTR<0.125 could be predicted factor of less invasive lesions in early-stage lung adenocarcinomas. Furthermore, the study suggested that the 3D CTR parameter is more accurate than the 2D CTR parameter for making these predictions.

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