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Hannah Emily Scholes
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P08 - Early Stage/Localized Disease - Epidemiology (ID 117)
- Event: WCLC 2020
- Type: Posters
- Track: Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P08.08 - Surgical Resection of Non-Small Cell Lung Cancer: Uncertain Resection Margins and Patterns of Recurrence (ID 3632)
00:00 - 00:00 | Presenting Author(s): Hannah Emily Scholes
- Abstract
Introduction
Incomplete microscopic surgical resection (R0) for Non-Small Cell Lung Cancer (NSCLC) affects prognosis and informs further treatment. There is insufficient data exploring the impact of pattern of disease recurrence and proposed uncertain resection margin status (R(Un)).
Methods
A retrospective, single-institute analysis of patients undergoing surgical resection of NSCLC, between 01/04/2008 and 30/3/2017. Data was retrieved from digitally held case and histopathology records. Certainty of resection margin was derived (R0 vs R(Un)). Electronic radiology records were used to determine Pattern of First Recurrence (PoR, defined as locoregional or distant). Standard statistical methods were used to assess correlations between continuous and categorical variables. Univariate and multivariate analysis models were used to assess survival and recurrence-free survival differences.
Results
1503 patients remained within the study, following exclusion of non-anatomic resections, second primary NSCLCs or additional non-pulmonary malignancies within the follow-up period. After 38 months, the minimum follow-up period, 514 cases (34.1%) had tumour recurrence and 691 patients (46.0%) remained alive. Correlations were demonstrated between PoR and T-Stage (p<0.001), Grade of Tumour Differentiation (p=0.002), N-Stage (p<0.001) and Conventional R-Status (p<0.001). No difference in PoR was seen between R0 and R(Un) cases. In both univariate and multivariate analysis locoregional pattern at first recurrence was strongly prognostic for survival (median survival 67 vs 42 months, HR=2.55, p<0.001). T-Stage, N-Stage and Lymphatic Invasion were found to be independent predictors for tumour recurrence.
ConclusionPattern of First Recurrence
N (% of Cases)
Locoregional vs Distant
Proposed R-Status
No Recurrence
Locoregional
Distant +/- Locoregional
0.122
R0
R(Un)
R1
411 (69.5)
505 (66.3)
73 (48.7)
79 (13.4)
134 (17.6)
43 (28.7)
101 (17.1)
123 (16.1)
34 (22.7)
Correlations with PoR were as expected. When compared to other patterns of recurrence, a distant pattern of first recurrence was strongly negatively prognostic. Nevertheless, whilst R(Un) has previously demonstrated a worse prognosis than R0, R(Un) was not associated with increased locoregional recurrence or a reduced time to recurrence.
