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Jin-Shing Chen
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EP1.18 - Treatment of Locoregional Disease - NSCLC (ID 208)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment of Locoregional Disease - NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.18-15 - Surgical Results of Primary Mucoepidermoid Carcinoma of Lungs: A 9 Years' Experience (Now Available) (ID 1515)
08:00 - 18:00 | Author(s): Jin-Shing Chen
- Abstract
Background
Pulmonary mucoepidermoid carcinoma is a rare salivary-gland type lung cancer and accounts for 0.1%–0.2% of all primary lung malignancies. The optimal treatment of pulmonary mucoepidermoid carcinoma is not well determined. The aim of this study was to examine the surgical outcomes for the pulmonary mucoepidermoid carcinoma in our institution.
Method
From January 2010 to December 2018, we performed a retrospective review including all patients with primary pulmonary mucoepidermoid carcinoma of lung who underwent pulmonary resections in our institutions. The patients’demographic, clinical, and survival data were analyzed.
Result
A total of 3124 primary lung cancer patients underwent surgical resections by the same surgical team during the 8-year study period. 8 cases (0.25%) patients who were diagnosed with primary mucoepidermoid carcinoma of the lung were analyzed in this study. The patients’ characteristics are shown in Table 1. The median age of all patients was 57 year-old (range: 22-75 year-old). Cough is the most common symptom (5 cases, 62.5%). 7 cases had a low-grade tumor, and all the cases were completely resected thoracoscopically. Two cases were resected by wedge resection because peripherally located, and two cases required bronchial reconstruction. There was no adverse effect after the operation. One case recived adjuvent chemotherapy due to nodal invasion. However, this case had disease progression with patella bone metastasis 5 months after opeartion. The other cases were free of malignancy with a median follow-up of 27.2 months.
Conclusion
Complete surgical resection of a mucoepidermoid carcinoma of lungs can be atributed to a long-term survival in patients. For an elederly patient with a peripherally located tumor, wedge rsection with mediastinal lymphnode dissection could be an alternative treatment.
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P1.01 - Advanced NSCLC (ID 158)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.01-132 - Clinicopathological and Genomic Comparisons Between Different Histologic Components in Combined Small Cell and Non-Small Cell Lung Cancer (ID 1559)
09:45 - 18:00 | Author(s): Jin-Shing Chen
- Abstract
Background
Histologic transformation from adenocarcinoma to small cell lung cancer (SCLC) is one of the mechanisms of acquired resistance after epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment. Furthermore, de novo combined SCLC/non-small cell lung cancer (NSCLC) have occasionally been reported; however, their mutational statuses and clinicopathological features have not yet been elucidated. In this study, we aimed to profile the genetic backgrounds of these 2 different histologic components by investigating patients with de novo combined SCLC/NSCLC as well as those with lung adenocarcinoma who experienced SCLC transformation after TKI treatment.
Method
Four patients with de novo combined SCLC/NSCLC were investigated, as were 4 other patients with lung adenocarcinoma who experienced SCLC transformation after TKI treatment. The different histologic components of the tumors in each patient were tested for thyroid transcription factor-1, p40, synaptophysin, chromogranin A, p53, retinoblastoma protein (Rb), and achaete-scute homolog 1 (ASCL1) via immunohistochemistry, and were macroscopically dissected for mutational analysis using next-generation sequencing with the Oncomine Focus Assay and Comprehensive Assay panel.
Result
Our study comprised two groups of patients: the first group were patients with de novo combined SCLC/NSCLC and the second group were lung adenocarcinoma with SCLC transformation after TKI treatment. De novo combined SCLC/NSCLC patients have poor prognoses and poor responses to EGFR TKI. In both groups, identical EGFR/TP53/RB1 mutations and p53/Rb expression patterns were observed in both SCLC and NSCLC components. A high frequency of activating mutations involving PI3K/AKT1 signaling pathway was observed in de novo combined SCLC/NSCLC and also in the SCLC component of the second group after TKI treatment. Nuclear ASCL1 expression was present in SCLC but absent or barely present in adenocarcinoma in 7 cases.
Conclusion
Our data imply that inactivation of TP53/RB1 function is a possible early event in the histogenesis of synchronous and metachronous SCLC/NSCLC. Moreover, the non-adenocarcinoma (SCLC) component might arise from the adenocarcinoma (NSCLC) component through a mechanism that involves the activation of the ASCL1 and PI3K/AKT1 signaling pathways.
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P1.07 - Nursing and Allied Professionals (ID 171)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Nursing and Allied Professionals
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.07-08 - Screening for Fear of Cancer Recurrence in Operable Lung Cancer Patients-Scale Validation and Current Status (ID 2257)
09:45 - 18:00 | Author(s): Jin-Shing Chen
- Abstract
Background
Fear of cancer recurrence (FCR) is one of the most distressing concerns for cancer patients. A brief scale to screen FCR is important for use in busy clinical oncology settings. The purposes of the study are to (1) translate the 7-item fear of cancer recurrence scale (FCR7) into Chinese and validate the psychometrics of the 7-item Chinese version (FCR7-C), and (2) explore the level of FCR in a cohort of early-stage lung cancer patients after tumor resection surgery in Taiwan.
Method
Eligible subjects were recruited from chest surgery outpatient department in a medical center in Taiwan. The FCR7 was first translated and back translated between English and Chinese. The translated FCR7-C was evaluated for content validity and internal consistency reliability (Cronbach's alpha). Construct validity was determined by evaluating correlations between FCR7-C theoretical assumptions and confirmatory factor analysis (CFA).
Result
In our cohort of 160 patients, the FCR7-C was shown to have satisfactory content validity and internal consistency reliability (Cronbach’s α = 0.9). The uni-dimensional structure was confirmed by CFA that showed a good fit for the model. The FCR7-C score correlates positively with the degree of physical symptoms, anxiety, and depression, but correlates negatively with patient age, performance status, and quality of life. We found that 81.9% of patients reported at least some FCR, with a mean FCR severity of 15.2 (SD= 7.8).
Conclusion
FCR7-C is a brief assessment with good psychometrics. For operable lung cancer patients, FCR is still a concern for most of the early stage lung cancer patients though it is not very severe. We strongly suggest its use for screening cancer patients for FCR to allow for appropriate interventions in lung cancer patients.
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P2.09 - Pathology (ID 174)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.09-29 - Correlation of Tumor Spread Through Air Spaces and Clinicopathological Characteristics in Surgically Resected Lung Adenocarcinomas (ID 1547)
10:15 - 18:15 | Author(s): Jin-Shing Chen
- Abstract
Background
Tumor spread through air spaces (STAS) has recently been reported as a novel invasive pattern in lung adenocarcinoma, but the correlation between other clinicopathological and genetic profiles has not been well studied. The aim of this study was to investigate these correlations in patients with surgically resected lung adenocarcinoma.
Method
Five hundred consecutive patients with lung adenocarcinoma who underwent curative lung tumor resection and with available STAS profile were reviewed retrospectively from January to December 2016. The correlations of STAS presence and clinicopathological and genetic characteristics were analyzed.
Result
One hundred thirty-four patients (26.8%) had positive STAS. The pathological stage of these patients was adenocarcinoma in situ, IA, IB, II, and III in 25 (5%), 343 (68.6%), 63 (12.6%), 29 (5.8%), and 40 (8%), respectively. Multivariate analysis showed that the presence of STAS was significantly correlated to higher T (p=0.001) and N (p=0.032) stages, moderate/poor differentiation (p=0.001), and the presence of lymphovascular invasion (p=0.001). Although positive epidermal growth factor receptor mutation and non-lepidic histologic subtypes were correlated with the presence of STAS in the univariate analysis, they were not significantly correlated with the presence of STAS in the multivariate analysis (p=0.676 and 0.286, respectively).
Conclusion
STAS was significantly correlated with several invasive clinicopathological characteristics, including higher T and N stages, moderate/poor differentiation, and the presence of lymphovascular invasion in surgically resected lung adenocarcinoma. The correlation may lead to poor clinical outcomes in patients with positive STAS. Based on our results and current evidence, the presence of STAS may be considered as a staging profile in future staging system.
