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Enrico Maria Silini
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P2.09 - Pathology (ID 174)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.09-02 - Exploring the Features of the Short and Long-Term Survivors for Lung Adenocarcinoma: A Single Center Experience (Now Available) (ID 2808)
10:15 - 18:15 | Author(s): Enrico Maria Silini
- Abstract
Background
The aim of this study was to identify an objective way to define a long-term survivors(LTS) and short-term survivors(STS) in patients with surgically resected lung adenocarcinoma (ADK), and secondly to find peculiar clinicopathological features in these two groups of patients.
Method
all patients who underwent major lung resection for lung ADK from 2000 to 2015 were studied.LTS and STS were extrapolated considering the overall survival(OS) and pathological tumour stage:the first and the fourth quartile of those patients with cancer-related death were considered for statistical analysis.
Result
from 600 ADK patients we found 79 STS and 77 LTS;clinico-pathologic baseline characteristics are presented in Table 1.Considering STS patients, smoking habit, histotype, tumour necrosis, pleural invasion and pathological stage were significantly associated with OS at univariate analysis (Fig.1). In LTS patients, smoking habit, neoadjuvant chemotherapy, tumour-infiltrated lymphocytes and pathological stage were significantly associated with OS (Fig.2).On multivariate analysis, smoking status, lymphoid infiltrate, pleural invasion and stage remained significantly associated with OS (Table 2).
Table 1
Variable
Full samplea
STS (N=79)a
LTS (N=77)a
p-value
Age at diagnosis (median)
68 (62-74)
68 (61-74)
69 (64-75)
0.301
Gender (M:F)
110:46 (70.5%:29.5%)
60:19 (24,1%:75,9%)
27:50 (35,1%:64,9%)
0.131
Smoking status
<0.001
Never smoker
23 (19,6%)
5 (6,8%)
18 (27,3%)
Smoker + Former smoker
117 (81,4%)
69 (93,2%)
48 (72,7%)
Other previous primary tumor
0.936
Yes
43 (27,6%)
22 (27,8%)
21 (27,3%)
No
113 (72,4%)
57 (72,2%)
56 (72,7%)
Side
0.079
Right
70 (44,9%)
30 (38,0%)
40 (51,9%)
Left
86 (55,1%)
49 (62,0%)
37 (48,1%)
Histotype
0.085
Lepidic
5 (3,2%)
0 (0,0%)
5 (6,5%)
Papillary
21 (13,5%)
11 (13,9%)
10 (13,0%)
Acinar
37 (23,7%)
16 (20,3%)
21 (27,3%)
Micropapillary
18 (11,5%)
8 (10,1%)
10 (13,0%)
Solid
75 (48,1%)
44 (55,7%)
31 (40,3%)
Grade
0.034
G1
2 (1,3%)
0 (0,0%)
2 (2,6%)
G2
23 (14,7%)
7 (8,9%)
16 (20,8%)
G3
131 (84,0%)
72 (91,1%)
59 (76,6%)
Lymphatic invasion
0.864
Yes
101 (64,7%)
51 (67,1%)
50 (65,8%)
No
51 (32,7%)
25 (32,9%)
26 (34,2%)
Blood invasion
0.128
Yes
47 (30,1%)
28 (36,4%)
19 (25,0%)
No
106 (67,9%)
49 (63,6%)
57 (75,0%)
Pleural invasion
0.439
PL0
78 (50,0%)
37 (46,8%)
41 (53,2%)
PL1
41 (26,3%)
24 (30,4%)
17 (22,1%)
PL2
20 (12,8%)
8 (10,1%)
12 (15,6%)
PL3
17 (10,9%)
10 (12,7%)
7 (9,1%)
Necrosis
0.419
Yes
70 (46,7%)
37 (50,0%)
33 (43,4%)
No
80 (53,3%)
37 (50,0%)
43 (56,6%)
Lymphoid infiltrate
0.787
Absent
57 (37,0%)
27 (35,1%)
30 (39,0%)
Mild
63 (40,9%)
34 (44,2%)
29 (37,7%)
Moderate
21 (13,6%)
9 (11,7%)
12 (15,6%)
Marked
13 (8,4%)
7 (9,1%)
6 (7,8%)
Neoadjuvant chemotherapy
0.371
Yes
11 (7,1%)
7 (8,9%)
4 (5,2%)
No
145 (92,9%)
72 (91,1%)
73 (94,8%)
Table 2
Variables
p-value.
HR
95% CI
Smoking Habit
0,003
2,317
1,325
4,052
Histotype
0,817
,951
,620
1,459
Tumor Necrosis
0,065
,667
,434
1,025
Limphoyd Infiltrate
0,024
1,598
1,063
2,402
Neoadjuvant CHT
0,160
,502
,192
1,313
Pleural Invasion
0,021
,421
,201
,879
Stage
0,002
,480
,305
,755
Conclusion
Our findings suggest that the unexpected survival of STS and LTS ADK-patients is determined by a concert of clinical and pathological features. Biological characterizazion of these kind of patients will likely improve the understanding of their unusual course.
