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S.J. Jang



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    P2.09 - Poster Session 2 - Combined Modality (ID 213)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Combined Modality
    • Presentations: 1
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      P2.09-012 - Prognostic Value of Tumor Survivin Expression in Stage III Non-small Cell Lung Cancer Patients Treated with Platinum-based Chemoradiation Therapy Followed by Surgery (ID 2473)

      09:30 - 09:30  |  Author(s): S.J. Jang

      • Abstract

      Background
      The potential prognostic value of survivin is variably reported in various stage of lung cancer. This study evaluated the correlation between tumor survivin expression before and after chemoradiation therapy (CRT) and prognosis in stage III non-small cell lung cancer (NSCLC) patients treated with platinum-based chemoradiation therapy followed by surgery

      Methods
      Medical records from 53 patients whose tissues were suitable for study were reviewed. Tissues were stained by immunohistochemistry and were estimated the degree of stain with scoring for survivin. Clinicopathologic parameters and survivin expression score were evaluated for a prognostic relationship with overall survival (OS) and time to recurrence (TTR).

      Results
      Pathologic complete response, residual nodal involvement and radiologic response after CRT were not related with OS or TTR. Tumor survivin expression on pre-treatment tissues was presented in 47 patients (88.7%). Pre-treatment survivin score was not related with TTR and OS (p = 0.249 and p = 0.601, respectively). There was no correlation between pre-treatment and post-treatment survivin score (p = 0.309). Downregulation of survivin and post-treatment survivin score (0 – 1) after chemoradiation showed significant improvement in OS (p = 0.04 and p = 0.033, respectively). Age, downregulation of survivin score, and post-treatment survivin score (0 – 1) were significant prognostic factors for survival by multivariate analysis.

      Conclusion
      Downregulation of survivin score and post-treatment low survivin score in stage III NSCLC treated with platinum-based chemoradiation therapy followed by surgery has a value of prognostic factor regardless pre-treatment survivin score. Further studies to evaluate the relation of survivin expression and platinum-based chemoradiation therapy are warranted in NSCLC.

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    P2.18 - Poster Session 2 - Pathology (ID 176)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Pathology
    • Presentations: 1
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      P2.18-002 - A comprehensive comparative analysis of the histomorphological features of ALK-rearranged lung adenocarcinoma based on driver oncogene mutations : frequent expression of epithelial-mesenchymal transition markers than other genotype (ID 221)

      09:30 - 09:30  |  Author(s): S.J. Jang

      • Abstract

      Background
      Molecular classification of lung cancer correlates well with histomorphologic features. However, detailed histomorphologic features which differentiate ALK rearranged tumors from ALK wild type has not been fully evaluated. To investigate histomorphologic features of tumors harboring ALK rearrangement to evaluate the predictive significance of morphologic characterization, we compared the histomorphological analysis between ALK-rearranged and ALK negative lung adenocarcinomas based on driver oncogene mutations.

      Methods
      Eighty resected ALK rearranged lung adenocarcinomas and two hundred thirteen resected ALK negative adenocarcinomas (91 EGFR mutated, 29 K-ras mutated and 93 triple-negative) were analyzed for several histomorphological parameters and histologic subtype based on newly proposed IASLC/ATS/ERS classification.

      Results
      ALK rearranged tumors were associated with a younger age at presentation, frequent nodal metastasis and higher stage at diagnosis, compared with patients with other genotypes. ALK rearranged tumors were more likely to show solid predominant pattern (43.8%, 35/80) than other genotypes (p<0.001) and a lepidic predominant histology was not observed in ALK rearranged tumors (p<0.001). In ALK rearranged tumors, considerable number of the tumors (67.5% , 54/80) contained at least 5% solid pattern but only small number of the tumors (12.5%, 12/80) contained at least 5% lepidic pattern, compared with other genotypes (p<0.001). The most significant morphological features distinguishing ALK rearranged tumors from ALK negative tumors were cribriform formation (OR: 3.253, p=0.028), presence of mucin-containing cells (OR: 4.899, p=0.008), close relation to adjacent bronchioles (OR: 5.361, p=0.001), presence of psammoma body (OR: 4.026, p=0.002) and solid predominant histological subtype (OR: 13.685, p=0.023). ALK-rearranged tumors exhibited invasive histomorphological features, aggressive behavior and frequent expression of epithelial-mesenchymal transition markers (loss of E-cadherin and expression of vimentin) compared with other genotype (p =0.015). Spatial proximity between bronchus and ALK-rearranged tumors and frequent solid histologic subtype with p63 expression may cause diagnostic difficulties to differentiate squamous cell carcinoma in the small biopsy, whereas p40 was rarely expressed in ALK-rearranged adenocarcinoma.

      Conclusion
      Knowledge of these features may improve the diagnostic accuracy and lead to a better understanding of the characteristic behavior of ALK-rearranged tumors.