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Yaxing Shen



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    MA02 - Miscellaneous Topics in the Management of Early Stage Lung Cancer (ID 116)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 2
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      MA02.04 - Discussant - MA02.01, MA02.02, MA02.03 (ID 3718)

      10:30 - 12:00  |  Presenting Author(s): Yaxing Shen

      • Abstract

      Abstract not provided

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      MA02.12 - Discussant - MA02.09, MA02.10, MA02.11 (ID 3720)

      10:30 - 12:00  |  Presenting Author(s): Yaxing Shen

      • Abstract

      Abstract not provided

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    P1.13 - Staging (ID 181)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Staging
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.13-03 - Lung Adenocarcinomas Manifesting as Radiological Part-Solid Nodules Define a Special Clinical Subtype (ID 35)

      09:45 - 18:00  |  Presenting Author(s): Yaxing Shen

      • Abstract

      Background

      According to guidelines from the Fleischner Society in 2017, subsolid nodules are categorized into pure ground glass nodules (pGGNs) having only a GGO component and part-solid nodules having both GGO and solid components on thin-section computed tomography (TS-CT). Persistent part-solid nodules with solid components ≥ 6mm should be considered highly suspicious.Clinicopathologic features and prognostic predictors of radiological part-solid lung adenocarcinomas were unclear.

      Method

      We retrospectively compared clinicopathologic features and survivals of part-solid tumors with those of pure ground glass nodules (pGGNs) and pure solid tumors receiving surgery at Fudan University Shanghai Cancer Center, and evaluated prognostic implications of consolidation-to-tumor ratio (CTR), solid component size and tumor size for part-solid lung adenocarcinomas.

      figure 1副本.png

      Result

      911 patients and 988 pulmonary nodules (including 329 part-solid nodules (PSNs), 501 pGGNs & 158 pure solid nodules) were analyzed. More female patients (P=0.015) and non-smokers (P=0.003) were seen in PSNs than those in pure solid nodules. Prevalence of lymphatic metastasis was lower in PSNs than that in pure solid tumors (2.2% vs 27%, P=0.000). 5-year lung cancer specific recurrence free survival (LCS-RFS) and overall survival (OS) of PSNs were worse than those of pGGNs (P<0.001; P=0.042), but better than those of pure solid tumors (P<0.001; P<0.0001), respectively. CTR (OR: 12.90; 95% CI: 1.85-90.04), solid component size (OR: 1.45; 95% CI: 1.28-1.64) and tumor size (OR: 1.23; 95% CI: 1.15-1.31) could predict pathologic invasive adenocarcinoma for PSNs. None of them could predict the prognosis. Patients receiving sublobar resection had comparable prognoses with those receiving lobectomy (5-year LCS-RFS: P=0.178; 5-year LCS-OS: P=0.319). Prognostic differences between patients with systemic lymph node dissection (sLND) and those without sLND were statistically insignificant.

      Table1 Baseline clinicopathologic characteristics of objects in this study

      All

      N=988

      Part Solid nodule

      N=329

      Pure Ground Glass nodule

      N=501

      Pure Solid nodule

      N=158
      P value
      Age (Mean±SD) 56.49±10.83 58.89±9.71 53.64±10.86 60.54±10.52 0.000
      Gender 0.015
      Male 277(30.4) 91 (28.9) 124 (28.2) 62 (39.5)
      Female 634(69.6) 224 (71.1) 315 (71.8) 95 (60.5)
      Smoking status 0.003
      Smoker 153(16.8) 52 (16.5) 62(14.1) 39(24.8)
      Non-smoker 758(83.2) 263(83.5) 377(85.9) 118(75.2)
      Tumor size(mm) 15.14±7.38 20.51±7.18 10.22±3.84 19.54±5.58 0.000
      Location 0.009
      RUL 364 (36.8) 126 (38.3) 197 (39.3) 41 (25.9)
      RML 67 (6.8) 21 (6.4) 29 (5.8) 17 (10.7)
      RLL 181 (18.3) 48(14.6) 93 (18.6) 40 (25.3)
      LUL 266 (26.9) 98 (29.8) 130 (25.9) 38 (24)
      LLL 110 (11.2) 36 (10.9) 52 (10.4 ) 22 (14.1)
      Surgery 0.000
      Wedge resection 456(46.2) 72(21.9) 370(73.8) 14(8.9)
      Segmentectomy 97(9.8) 33(10.0) 58(11.6) 6(3.8)
      Lobectomy 435(44.0) 224(68.1) 73(14.6) 138(87.3)
      Pathology 0.000
      AIS/MIA 509(51.5) 56(17.0) 447(89.2) 6(3.8)
      IAD 479(48.5) 273(83.0) 54(10.8) 152(96.2)
      Lepidic predominant 154(32.6) 104(38.8) 30(55.5) 30(55.5) 0.000
      Solid/Micropapillary predominant 21(4.5) 4(1.5) 1(1.9) 16(3.4) 0.000
      Acinar/Papillary predominant 290(61.4) 157(58.6) 22(40.7) 111(74.0) 0.000
      Mucinous adenocarcinoma 7(1.5) 3(1.1) 1(1.9) 3(2.0) 0.753
      Pathologic N status 0.000
      N0 904 (94.9) 305(97.8) 488 (100) 111(73)

      N1/2 48(5.1) 7(2.2) 0 (0) 41 (27)
      Conclusion

      Part-solid lung adenocarcinoma showed different clinicopathologic features compared with pure solid tumor. CTR, solid component size and tumor size could not predict the prognosis. Part-solid lung adenocarcinomas define one special clinical subtype.