Virtual Library
Start Your Search
E. Comans
Author of
-
+
P2.05 - Interventional Diagnostic/Pulmonology (ID 168)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Interventional Diagnostics/Pulmonology
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.05-03 - Tumor Atelectasis Gives Rise to Solid Appearance in Pulmonary Adenocarcinomas (ID 758)
10:15 - 18:15 | Author(s): E. Comans
- Abstract
Background
Ground glass opacities (GGO) on CT scan, if malignant, correlate with adenocarcinoma in situ in histology. Solid appearance on HRCT, either ground glass nodule (GGN) or a solid nodule (SN), is considered to be invasive carcinoma. Histological recognition of invasion in pulmonary adenocarcinoma revealed low kappa scores among expert pathologists. A likely explanation is that morphological collapse is not taken into account in the WHO lung cancer classification.
This study aims to compare radiological features in HRCT and histological features of primary adenocarcinomas in resection specimen for the presence of collapse.
Method
Patients with primary adenocarcinoma in the lung, resected between November 2016 and November 2018, were selected. HRCT scans and CT-PET imaging were evaluated for GGO, GGN , and SN. For pathology diagnosis the 2015 WHO classification was used. Both evaluations were blinded for other information. Lepidic growth pattern with collapse was considered if reduction of air in the histological section was present, while underlying pulmonary architecture was maintained (organoid pattern without invasion).
Result
In total 47 lesions of 41 patients were evaluated. The number of GGO, GGN and solid nodules was 2, 8 and 37, respectively. Lepidic growth pattern with collapse was present in both GGO lesions, 7 out of 8 (88%) GGN lesions and 24 out of 37 (65%) solid lesions.
Remarkably, pre-existing pulmonary architecture with air spaces between alveoli covered with epithelial tumor cells (lepidic pattern) can be detected in over 50% of the adenocarcinomas with solid appearance on HRCT. This can only be explained by tumor related atelectasis (collapse) in vivo.
Conclusion
Tumor related atelectasis is a frequent finding in pulmonary adenocarcinomas and may be a feature in a solid appearance on HRCT. Therefore, a solid appearance on HRCT cannot be solely attributed to invasion, as has been the assumption until now.
-
+
P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.11-36 - The Role of FDG-PET Scans in Pre-Invasive Endobronchial Lesions (Now Available) (ID 2010)
10:15 - 18:15 | Author(s): E. Comans
- Abstract
Background
Pre-invasive endobronchial squamous lesions, especially high-grade lesions, may serve as risk markers for developing lung cancer. However, it remains difficult to determine whether individual lesions will progress to lung cancer. 18 fluorodeoxyglucose (18F-FDG)-positron emission tomography (PET) is currently used as a golden standard for staging patients with lung cancer and to monitor treatment response. The role of FDG-PET-scans in patients with pre-invasive lesions has not yet been established. In our study we report the outcome of surveillance of 40 subjects with pre-invasive endobronchial lesions and investigate the use of 18F-FDG-PET-scans as part of a surveillance program.
Method
We retrospectively selected patients with pre-invasive endobronchial lesions who underwent pre-treatment FDG-PET scans at the VU Medical Center Amsterdam between 1995 and 2016. Patients with signs of invasive carcinoma at baseline, as confirmed by histology, were excluded. Autofluorescence bronchoscopy (AFB) was used for tissue sampling. The minimum follow up period was three months and the group underwent close surveillance with repeated AFB. Outcomes included progression-free survival (PFS) and overall survival (OS).
Result
Among 40 included patients, 17 patients had a positive FDG-PET-scan at baseline of which 13 (76,5%) patients developed lung cancer during follow up. Twenty-three patients had a negative FDG-PET of which 6 (26,1%) developed lung cancer during follow-up. The FDG-PET-positive group had a median progression free survival of 5,0 months and the FDG-PET-negative group 33,0 months (p<0,0001, Figure 2). There was no significant difference in overall survival between both groups.
Conclusion
Our present work demonstrates that subjects with pre-invasive endobronchial lesions and a positive FDG-PET scan are at high risk to develop lung cancer. We reported a significantly longer progression free survival in patients with pre-invasive lesions with a negative FDG-PET scan. This suggests that FDG-PET scan can be used to select patients that require more radical cancer treatment.
