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Yu Izaki
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P2.17 - Treatment of Early Stage/Localized Disease (ID 189)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.17-01 - Analysis of Clinical Features and Prognosis of Non-Small Cell Lung Cancer Exceeding 30 mm Depending on the Ground Glass Opacity (GGO) Ratio (ID 230)
10:15 - 18:15 | Author(s): Yu Izaki
- Abstract
Background
The ground glass opacity (GGO) ratio is associated with the prognosis of small (<30 mm) non-small cell lung cancer (NSCLC). However, the clinical features, especially the GGO ratio, and prognosis of NSCLC exceeding 30 mm are not well known. Therefore, this study aimed to determine the characteristics of patients with NSCLC exceeding 30 mm and analyze the clinical significance of the GGO ratio on prognosis.
Method
Totally, 271 patients with NSCLC tumors exceeding 30 mm on preoperative computed tomography scans and who underwent complete resection at our institution between January 2007 and December 2017 were included. The patients were divided into three groups based on the GGO ratio: pure solid tumors, GGO ratio 0–40%, and GGO ratio ≥40%. The cut-off value of 40% was determined based on the recurrence rate for each GGO ratio group. Clinical feature and prognosis of each group were analyzed.
Result
Of the included patients, 147 (54%) had pure solid nodule, 67 (25%) had nodules with a GGO ratio 0–40%, and 57 (21%) had nodules with a GGO ratio ≥40%. Among the patients with a GGO ratio ≥40%, 10 underwent limited resection (segmentectomy in 9 patients and wedge resection in 1); no patients experienced recurrence. Among the 147 patients with pure solid nodules, 47 (32%) experienced recurrence. Among the 67 and 57 patients with GGO ratio 0–40% and GGO ratio ≥40%, 16 (24%) and 2 (4%), respectively, experienced recurrence. The 3-year recurrence-free survival (RFS) rate was significantly shorter in patients with pure solid nodules (60.5%) than in patients with GGO ratio 0–40% (74.0%; p=0.010) and GGO ratio ≥40% ( 93.6%; p<0.001). Moreover, RFS was significantly shorter in patients with GGO ratio 0–40% than in patients with GGO ratio ≥40% (p=0.009). Similar results were observed for overall survival (OS). The 3-year OS rate was significantly shorter in patients with pure solid nodules (79.1%) than in patients with GGO ratio 0–40% (88.2%; p=0.046) and GGO ratio ≥40% (95.6%; p<0.001). Moreover, OS was shorter in patients with GGO ratio 0–40% than in patients with GGO ratio ≥40% with marginal significance (p=0.052).
Conclusion
A pure solid nodule was a major component among NSCLC tumors exceeding 30 mm. Among such patients, as the GGO ratio decreased, the recurrence rate increased. A GGO ratio of 40% is the appropriate cut-off value, and patients with GGO ratio ≥40% have better prognosis compared to patients with GGO ratio <40% or pure solid nodules. The prognosis of patients with GGO ratio ≥40% who undergo limited resection may be similar to that of patients undergoing lobectomy, the standard operation procedure.
