Author of

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  P3.18 - Poster Session 3 - Pathology (ID 177)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Pathology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12771

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    P3.18-002 - Predicting stratification for recurrence of early lung adenocarcinoma based on 7th TNM classification and IASLC/ATS/ERS classification (ID 1146)

    09:30 - 09:30  |  Author(s): M. Ito
    • Abstract

    Background
    Seventh TNM classification for lung cancer and IASLC/ATS/ERS classification for pathological subtype of lung adenocarcinoma have been released independently. They have especially changed classification of small sized (≤ 3.0cm) and nodal negative adenocarcinomas. However, when utilizing them simultaneously, it is not clear which factors of each classification are useful to predict malignant potential of tumor.

    Methods
    We reviewed 154 pT1a-1bN0M0 adenocarcinoma cases resected between 1990 and 2011. Cases with adjuvant chemotherapy were excluded. 154 cases were subdivided into T1a or T1b cases according to 7th TNM classification. On the other hand, according to IASLC/ATS/ERS classification, reviewed cases were also subdivided into adenocarcinoma in situ/minimally invasive adenocarcinoma (AIS/MIA) or invasive adenocarcinoma (invasive Ad). Survival outcomes were evaluated based on these subclassfication methods.

    Results
    There were 84 AIS/MIA cases and 75 invasive Ad cases. T1a included 77 cases of AIS/MIA and 50 cases of invasive Ad. T1b included 7 cases of AIS/MIA and 25 cases of invasive Ad. T1a included significantly more AIS/MIA cases compared with T1b (p<0.001). The significance was confirmed about disease free survival (DFS) between T1a and T1b (96.7% vs 72.7, p<0.001). Pathological subtype also reached significance in DFS between AIS/MIA and invasive Ad (97.4% vs 85.7%, p<0.001). When combining these classifications, DFS of T1a-1b AIS/MIA (N=84), T1a invasive Ad (N=50), T1b invasive Ad (N=20) were 97.4%, 95.6% and 69.2%, respectively. The difference of DFS between T1a-1b AIS/MIA and T1b invasive Ad were more notable in comparison to single classification method. Relapse-free probability of T1a-1b AIS/MIA was 100%.

    Conclusion
    Combination of 7th TNM classification and IASLC/ATS/ERS classification were more useful compared with single method classification to predict T1a-1bN0M0 lung adenocarcinoma recurrence. T1b invasive Ad cases were identified as worsen subtypes than T1a-1b AIS/MIA. AIS and MIS might be handled equally regardless of tumor size.