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J.K. Park



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    P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P2.02-015 - Prognostic Significance of Histologic Subtype in Stage I Non-Small Cell Lung Cancer (ID 2381)

      09:30 - 09:30  |  Author(s): J.K. Park

      • Abstract
      • Slides

      Background:
      Non-small cell lung cancer consist of several histologic types. Among them, pulmonary adenocarcinoma has histologic heterogeneity. Current staging system relied on anatomical involvement of lung cancer. Histologic subtype has not been reflected in the TNM stage of lung cancer although there is some positive reports on prognostic factor. This study aimed to evaluate histologic difference as prognostic factor in stage I lung cancer.

      Methods:
      We retrospectively reviewed 269 patients with stage I adenocarcinoma and squamous cell carcinoma after curative pulmonary resection at single institute in Korea from August 2010 to December 2013. Adenocarcinoma was divided into 3 groups according to lepidic component; group 1(lepidic component ≥50%), group 2(lepidic component <50%), and group 3(no lepidic component). We compared these three groups with squamous cell carcinoma.

      Results:
      Mean tumor size of squamous cell carcinoma was larger than other three groups(2.8cm vs 1.9cm, 2.3cm, 1.9cm, p<0.001). There was no difference between group 3 and squamous cell carcinoma in the presence of pleural invasion(p=0.386) or vascular invasion(p=0.930), but lymphatic invasion was more frequent in squamous cell carcinoma(p=0.018)(Table 1). Three-year recurrence free survival of group 1, group 2, group 3 and squamous cell carcinoma were 98.5%, 86.8%, 74.3%, and 66.3%, respectively. (group 1 vs group 2, p=0.077; group 2 vs group 3, p=0.023; group 3 vs squamous cell carcinoma, p=0.907)(figure). Multivariate analysis showed that these 4 grouping was the statistically significant risk factor for the recurrence (HR 1.719, 95% confidence interval 1.051-2.811, p=0.031) Table 1. Clinicopathologic characteristics

      Group 1(n=74) Group 2(n=119) Group 3(n=36) Sqcc(n=40) p value
      Age 61.2(±9.2) 65.0(±10.0) 65.3(±10.0) 67.3(±1.7) 0.009
      Female 45.9% 69.7% 25.0% 12.5% <0.001
      Smoking history(pack years) 7.8(±14.7) 5.2 (±11.8) 20.8 (±22.9) 35.4 (±26.2) <0.001
      Procedures Standard resection Limited resection 86.5% 13.5% 86.6% 13.4% 83.3% 16.7% 75.0% 25.0% 0.337
      SUVmax 1.9 (±1.7) 3.8 (±3.3) 4.7 (±3.8) 10.0(±5.8) <0.001
      Tumor size 1.9 (±0.8) 2.3 (±0.9) 1.9 (±0.6) 2.8(±1.0) <0.001
      Number of dissected lymph nodes 12.7 (±7.6) 14.6 (±9.9) 11.1 (±8.1) 14.0 (±10.1) 0.181
      Pleural invasion 6.8% 27.7% 25.7% 15.4% 0.003
      Lymphatic invasion 13.5% 32.8% 25.7% 53.8% <0.001
      Vascular invasion 1.4% 10.9% 14.3% 15.0% 0.037
      Figure 1



      Conclusion:
      Among stage I adenocarcinoma, the prognosis of non lepidic component adenocarcinoma was poorer than lepidic adenocarcinoma. Although the malignant potential of squamous cell carcinoma was higher than adenocarcinoma in this study, the prognosis was not different between non lepidic component adenocarcinoma and squamous cell carcinoma. We expect these histologic prognosis factor will be considered in the new staging system.

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