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N. Usami
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O29 - Cancer Control & Epidemiology IV (ID 132)
- Event: WCLC 2013
- Type: Oral Abstract Session
- Track: Prevention & Epidemiology
- Presentations: 1
- Moderators:P. Zimmerman, N. Kurimoto
- Coordinates: 10/30/2013, 10:30 - 12:00, Bayside 103, Level 1
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O29.05 - Prognostic Impact of the Tumor Size Eliminating the Ground Glass Opacity Component: Modified Clinical T Descriptors of the TNM Classification of Lung Cancer (ID 751)
11:15 - 11:25 | Author(s): N. Usami
- Abstract
- Presentation
Background
The presence of ground glass opacity (GGO) on high-resolution computed tomography (HRCT) is well known to be pathologically closely associated with adenocarcinoma in situ. Recently, measuring the tumor diameter including areas of GGO on HRCT has been reported to possibly overestimate the T status. The purpose of this study was to evaluate the significance of the tumor size measured eliminating the area of GGO on HRCT as a prognostic factor and to propose a refined TNM classification based on modified T descriptors.Methods
Four hundred and seventy-five patients with clinical T1a-T2bN0M0 non-small cell lung cancer underwent surgical resection. All tumors were reclassified based on the diameter measured eliminating the GGO area on HRCT according to the 7th TNM classification of lung cancer. We defined this new classification as modified T descriptors categorized into four groups: mTis+T1a, mT1b, mT2a and mT2b. The overall survival rates of the patients in the current and modified staging groups were evaluated.Results
The 5-year survival rates were 88% and 82% in the patients with T1a and T1b tumors and 90% and 75% in the patients with mTis+T1a and mT1b tumors, respectively. The differences in the survival of the patients classified using mTis+T1a and the other modified T descriptors were more clearly separated statistically than those of the patients classified using the current T1a and other T descriptors.Conclusion
The use of clinically modified T descriptors of the tumor size measured eliminating the GGO component on HRCT may more clearly classify the prognoses of patients with early lung cancer.Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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P1.12 - Poster Session 1 - NSCLC Early Stage (ID 203)
- Event: WCLC 2013
- Type: Poster Session
- Track: Medical Oncology
- Presentations: 1
- Moderators:
- Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level
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P1.12-012 - A Comparison of Clinicopathologic Features and Survival Outcomes between the Lung Cancer Patients with Adenocarcinoma and Squamous Cell Carcinoma: Stage I Disease of Squamous Cell Carcinoma is there? (ID 1811)
09:30 - 09:30 | Author(s): N. Usami
- Abstract
Background
Patients with lung cancer should be treated differently based on their histologic subtypes because of the disparities in tumor aggressiveness and treatment response. In addition to epidermal growth factor receptor tyrosine kinase inhibitor, recent chemotherapeutic agents such as pemetrexed and bevacizumab have dissimilar activities between adenocarcinoma (AD) and squamous cell carcinoma (SQ). Therefore, it would be important to reevaluate the clinicopathologic features of the two major subtypes, both of which were classified as non-small cell lung cancer.Methods
Between 1995 through 2012, 2412 patients with primary lung cancer underwent pulmonary resection in Nagoya University and Aichi Cancer Center Hospital. For the present study, a total of 2057 patients with AD and SQ who underwent complete resection were extracted, and their clinicopathological features and outcomes were evaluated.Results
The cohort consists of 1585 ADs (77%) and 472 SQs (23%). Female sex, no history of smoking and smaller size of the tumor were distinct characteristics of AD patients, and higher age was that of SQ patients (p < 0.0001). Pathological stage I disease was found in 70% of AD patients and 41% of SQ patients. Significant difference was observed for overall survival with the 5-year survival rate of 78% in AD patients and 63% in SQ patients. Limited to stage I disease, SQ patients also showed significant worse outcomes (p < 0.0001). Since no survival difference was observed between pN0 and pN1 patients with SQ (p = 0.39), we tried to regard the pN0 patients as pN1 and restage them according to the newly defined N status. Thirty-seven stage IA and 42 stage IB patients were upstaged to stage IIA, 36 stage IB patients to stage IIB, and 47 stage IIB patients to stage IIIA. As a result, comparable survival curves were obtained between AD and SQ patients in stage II and IIIA.Conclusion
We identified some significant differences between patients with AD and SQ in the large-scale Japanese cohort. Especially, patients with stage I SQ showed a significantly worse outcome. Newly defined stage grouping applied for SQ patients provided comparable outcomes with those of AD patients. Therefore, stage I disease of SQ may not be there.
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P1.16 - Poster Session 1 - Other Thoracic Malignancies (ID 186)
- Event: WCLC 2013
- Type: Poster Session
- Track: Thymoma & Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level
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P1.16-002 - Histological impact of primary tumor on indication of repeated pulmonary metastasectomy (ID 1346)
09:30 - 09:30 | Author(s): N. Usami
- Abstract
Background
Lung is one of the most common metastatic sites from malignances. Although efficacy of pulmonary metastasectomy (PM) has been reported recently, the prevalence has not been enough among thoracic surgeons. Moreover, beneficial effects of repeated PMs for longer survivals have been poorly evaluated. The aims of this study are to examine the efficacy of repeated PMs (Re-PM) for re-recurred diseases and evaluate the histological impact of the primary tumor on the treatment.Methods
We retrospectively reviewed 263 patients who underwent PMs for various malignancies from 1996 through 2011. These factors below were evaluated; age, gender, origin of primary tumors, disease free interval (DFI) to the first PM, surgical procedure of PM, number of resected tumors, frequency of PMs, DFI after the first PM, overall survival after the first PM and prognosis.Results
Among 263 patients, 166 were male, and 98 were female. The median age was 60　years old (range: 7-85). Origins of primary tumors were following; 91 colorectum, 54 bone and soft tissue, 22 head and neck, 20 adnexa uteri, 17 urinary tract, 14 testis (germ cell tumor), 45 others. Mean number of resected nodules at the first PM was one, and the maximum was 19. Wedge resections were performed most frequently in 159 patients (60%), lobectomies in 69 (26%), segmentectomies in 32 (12%), and bilobectomies in 5 (2%). Re-PMs were indicated in 47 patients (18%). Among them, while the prevalence of Re-PM was 20% (18/91) in colorectal cancer patients, that is as high as 37% (20/54) in bone and soft tissue sarcoma patients. Estimated five-year survival rate of the whole patients was 50.6%. And that of patients without recurrence, with Re-PM and without Re-PM were 92.9, 58.5 and 14.5%, respectively. In univariate analyses, sublober resection of the first PM, DFI and presence of complete resection at the first PM were significant favorable factors for overall survival. In the multivariate analysis, sublober resection and presence of complete resection at the first PM were revealed to be the independent prognostic factors.Conclusion
The large portion of Re-PM patients had colorectal cancer, or bone and soft tissue sarcoma as their primary tumor. Re-PM may improve the survival of selected patients who experienced re-recurrence in lung after PM. Primary tumor of bone and soft tissue sarcoma were the most applicable histology for Re-PM.
