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Young Tae Kim



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    MA09 - Prognosis and Staging (ID 187)

    • Event: WCLC 2020
    • Type: Mini Oral
    • Track: Staging
    • Presentations: 1
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      MA09.01 - Chair (ID 4132)

      09:15 - 10:15  |  Presenting Author(s): Young Tae Kim

      • Abstract

      Abstract not provided

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    P45 - Screening and Early Detection - Radiological Risk Stratification (ID 182)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Screening and Early Detection
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P45.04 - Radiologic and Clinical Features of Screening-Detected Pulmonary Invasive Mucinous Adenocarcinoma (ID 2275)

      00:00 - 00:00  |  Author(s): Young Tae Kim

      • Abstract
      • Slides

      Introduction

      Invasive mucinous adenocarcinoma (IMA) is distinguished from non-mucinous adenocarcinoma with higher recurrence rate and poorer prognosis. The distinctive features of IMA had been suggested largely based on studies with advanced stage IMA and the data about whole spectrum of IMA are sparse, especially about early stage IMA. In this study, we evaluated the radiologic and clinical characteristics and the prognosis of screening-detected early stage IMA (SD-IMA).

      Methods

      Total of 93 patients who underwent curative surgery for screening-detected IMAs (≤3cm) from July 2013 to May 2019 were reviewed retrospectively. Data about radiologic characteristics, clinic-pathologic findings, and prognosis of all patients were obtained. The disease-free survival (DFS) was the primary endpoint for prognosis. The sensitivity of pretreatment histologic diagnosis and prognosis of SD-IMA were evaluated.

      Results

      Majority of patients were female (62.4%, n=58) and non-smoker (74.2%, n=69). The mean age of patients was 64 ± 10.1 years. The dominant locations of screening-detected IMAs were both lower lobes (73.2%, n = 68) and one-quarter of tumors were located in other than lower lobes (right upper or middle lobe – 12 (12.9%), left upper lobe – 13 (14%)). Eighty-seven (93.5%) nodules were located in the periphery one-third of the lung and very close from visceral pleura (mean distance from visceral pleura was 2.4±5.0mm). The SD-IMAs are dominantly solid and high consolidation pattern nodule in CT findings. Radiologic features were pure ground glass nodule in 6 (6.5%), part-solid nodule in 37 (39.8%) and solid nodule in 50 (55.7%). The lung-RADS categories were 4A or 4B in most of cases (90.3%). The median time from screening-detection to operation was 4 months (range: 1 - 137). The sensitivity of preoperative tissue diagnosis was 61.1%. One patient had to experience second operation due to incorrect frozen diagnosis. Extent of pulmonary resection were lobectomy in 70 (75.2%), segmentectomy in 14 (15.1%) and wedge resection in 9 (9.7%) patients. Pathologic stages of screening-detected IMAs were pIA in 72 (77.4%), pIB in 15 (16.1%), pIIB in 2 and pIVA in 3 patients. In genetic analysis, KRAS mutations (56%, 9/16) and TTF-1 mutations (50%, 8/16) were frequently observed. EGFR mutations and ALK rearrangements were detected in 3% (2/66) and 5.5% (4/73) of patients, respectively. The median follow-up duration was 31 months (range: 1 - 73). Recurrences occurred in 6 patients (pleural seeding - 2, contralateral pulmonary metastasis - 3 and combined nodal recurrence and contralateral pulmonary and brain metastasis - 1). The patients who developed pleural seeding had been performed percutaneous needle biopsy before surgery. No death occurred during follow-up period. The 3 and 5-year DFS rates were 93.1 % and 88.2%.

      Conclusion

      SD-IMA was mostly presented as part-solid or solid nodule at peripheral portion of lung. The accuracy of histologic diagnosis of SD-IMA with small tissue samples or frozen examination was not high. The surgeons have to plan the surgical procedures with preoperative radiologic findings. SD-IMA showed favorable prognosis after surgical treatment including sublobar resection based on radiologic results

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