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Geun Dong Lee



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    MA02 - Miscellaneous Topics in the Management of Early Stage Lung Cancer (ID 116)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Now Available
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      MA02.10 - Different Prognostic Impact of Lymphovascular Invasion Between Lobectomy and Sublobar Resection in Stage IA Non-Small Cell Lung Cancer: A Propensity Score–Matched Analysis (Now Available) (ID 2905)

      10:30 - 12:00  |  Author(s): Geun Dong Lee

      • Abstract
      • Presentation
      • Slides

      Background

      Lymphovascular invasion (LVI) has been reported as a risk factor in patients with stage I Non-Small Cell Lung Cancer (NSCLC). Although lobectomy is a standard treatment, sublobar resection may be performed in patients with stage IA NSCLC. This study aimed to evaluate the prognostic effect of LVI in stage IA patients who underwent lobectomy and sublobar resection.

      Method

      We retrospectively reviewed data from 2134 patients with stage IA NSCLC from 2007 to 2016. By using the Cox proportional hazard regression model, we calculated the prognostic impact of LVI quantitatively. To reduce the effects of observed confounding between LVI-positive and negative patients, propensity score matching (PSM) was applied in patients with lobectomy and sublobar resection, respectively.

      Result

      Among patients with stage IA NSCLC (n=2134), 184 (8.6%) were pathologically diagnosed with LVI, which were 144 (8.9%) in lobectomy group (n=1614) and 40 (7.7%) in sublobar resection group (n=520). In multivariable analysis, LVI was a significant risk factor for both overall survival (OS) and recurrence-free survival (RFS) (OS: hazard ratio [HR], 2.03; 95% confidence interval [CI], 1.39–2.96; p < .001; RFS: HR, 2.31; 95% CI, 1.68–3.17; p < .001). After PSM, the prognostic impact of LVI was shown much greater in patients with sublobar resection (HR = 1.77 and 2.51 for OS and RFS) than those with lobectomy (HR = 4.93 and 4.25 for OS and RFS).

      Conclusion

      The presence of LVI significantly affected OS and RFS in stage IA NSCLC patients. Survival outcomes were more affected by the presence of LVI in patients with sublobar resection than those with lobectomy. Subsequent completion lobectomy could be considered in patients diagnosed with LVI after sublobar resection.

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