Author of

• 34826

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  P38 - Pathology - Pathology/Staging (ID 108)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Pathology, Molecular Pathology and Diagnostic Biomarkers
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 34831

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    P38.05 - Clinical, Genetic, Radiological, and Pathological Characteristics of Cribriform Adenocarcinoma of the Lung (ID 915)

    00:00 - 00:00  |  Presenting Author(s): Akihiko Yoshizawa
    • Abstract
    • Slides

    Introduction
    

    Cribriform predominant adenocarcinoma of the lung (Cribri-ADC) is a recently described tumor growth pattern. However, its clinical impact has not been clearly determined. We analyzed 1057 Japanese patients with resected lung adenocarcinoma to clarify the clinicopathological significance of Cribri-ADC.

    Methods
    

    A cribriform pattern (Cribri-p) was defined by invasive back-to-back fused tumor glands with poorly formed glandular spaces or invasive tumor nests comprising tumor cells that were produced in the glandular lumina. Based on its histological characteristics, we differentiated Cribri-ADC from acinar adenocarcinoma and investigated its correlation with clinicopathological factors, disease-free survival (DFS), and overall survival (OS). Further, to clarify the computed tomography (CT) images of Cribri-ADC, we divided the Cribri-ADC patients into three groups and recorded pure ground-glass nodules (GGNs), part-solid nodules (PSNs), and solid nodules (SNs).

    Results
    

    Twenty-five patients (2.4%) had Cribri-ADC. This pattern was associated with younger age (P=0.019), vascular invasion (P=0.0025), spread through air spaces (P<0.0001), and ALK rearrangement (P=0.012). Of the available 20 cases for CT evaluation, while most cases (n=17, 85%) showed SNs, the remaining 3 cases showed PSNs (mean solid portion, 85.7%); however, no GGNs were observed. The DFS curves of patients with Cribri-ADC were identical to those of patients with solid adenocarcinoma; however, their OS curves were located between those of patients with papillary and acinar adenocarcinoma. Among the 10 patients who had tumor recurrences, 8 had EGFR mutations or ALK rearrangement, 6 of whom achieved relatively long survival (median, 64.6 months; range, 37.4–113 months) following treatment with tyrosine kinase inhibitors (TKIs). According to multivariate analysis, Cribri-ADC was not an independent predictor of recurrence or death.

    Conclusion
    

    Cribri-ADC is associated with a higher risk of recurrence; however, most patients can be successfully treated with TKIs. These data indicate that TKIs should be added to adjuvant therapy regimens for patients with Cribri-ADC.

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