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R. Eisenberg



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    P1.18 - Poster Session 1 - Pathology (ID 175)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Pathology
    • Presentations: 1
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      P1.18-017 - The prevalence of micrometastasis (MM) in discarded intrapulmonary lymph nodes (LN) in resected non-small cell lung cancer (NSCLC). (ID 3000)

      09:30 - 09:30  |  Author(s): R. Eisenberg

      • Abstract

      Background
      44% of pN0 NSCLC resection patients die within 5 years. We recently showed 12% of pN0 NSCLC resection specimens have discarded LN with metastasis on H&E microscopy. ACOSOG Z0040 demonstrated the prognostic impact of immunohistochemistry positive (IHC+) LN MM. In this report, we investigated the prevalence of IHC+ LN MM in patients with and without H&E + LN metastasis in discarded lung resection specimens.

      Methods
      Using a fastidious redissection special pathology examination (SPE) protocol, we retrieved LN from discarded NSCLC resection specimens after the routine pathology examination (RPE). All retrieved LN were examined for metastasis by H&E light microscopy. We matched 26 patients with 1 or more H&E+ LN (irrespective of whether detected on RPE or SPE) with 28 patients without detectable nodal metastasis. Fresh sections were cut from all retrieved LN tissue blocks of these 54 patients and stained with AE1/AE3 immunostain (Dako) at an independent institution. All slides were examined independently by pathologists at two different institutions, and discordant reports resolved at a consensus review session. The prevalence of IHC positivity was determined from the final consensus of pathologists.

      Results
      Figure 1

      Conclusion
      Micrometastatic disease is evident in a significant proportion of the LN retrieved from discarded NSCLC resection specimens, further extending the potential clinical implications of incomplete LN examination. IHC+ nodes were not found in LN from patients with H&E negative disease after fastidious examination by SPE. The survival implications of these findings will be investigated in future clinical trials.