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Jae Hyun Jeon



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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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      P2.17-38 - Predictive Factors for Lymph Node Metastasis in Patients with Clinical Stage I Part-Solid Lung Adenocarcinoma (ID 2998)

      10:15 - 18:15  |  Author(s): Jae Hyun Jeon

      • Abstract
      • Slides

      Background

      Accurate clinical staging of small part-solid nodule is essential for developing a treatment plan and evaluating suitability for minimally invasive surgery. The aim of this study was to evaluate predictive factors for metastasis of N1 and N2 lymph nodes in clinical stage I part-solid lung adenocarcinoma.

      Method

      Medical records of patients with clinical stage I part-solid adenocarcinoma who had undergone anatomic pulmonary resection with systematic node dissection or node sampling between January 2009 and June 2018 were retrospectively reviewed. To identify predictive factors for lymph node metastasis, univariate and multivariate logistic regression analyses were performed.

      Result

      Among the 602 patients in this study, the overall prevalence of lymph node metastasis was 3.7% (n = 22), which included 3.0% of N1 lymph nodes (n = 18) and 1.5% of N2 lymph nodes (n = 9). Combined N1 and N2 nodal involvement was found in 5 patients. Nodal metastasis was not observed in tumors with a solid part ≤1.0 cm (cT1mi and cT1a). The nodal metastasis rate in cT1b, cT1c, and cT2a tumors was 4.7% (10/215), 4.8% (3/63), and 12.9% (9/70), respectively. Predictive factors for N1 node metastasis included size of solid part (p = 0.001), and for N2 node metastasis included visceral pleural invasion (p < 0.001) by multivariate analysis. The ratio of ground glass opacity was not associated with lymph node metastasis.

      ln metastasis.jpg

      Conclusion

      Among the patients with clinical stage I part-solid adenocarcinoma, 3.7% of the patients showed unexpected lymph node metastasis, and large size of solid part and visceral pleural invasion of the tumor were predictive factors of lymph node metastasis in clinical stage I part-solid adenocarcinoma. Sytemic lymph node dissection and anatomic pulmonary resection should be performed, especially in those who have the larger size of solid part and suspicion of visceral pleural invasion.

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