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L. Ren



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    O13 - Limited Resections (ID 101)

    • Event: WCLC 2013
    • Type: Oral Abstract Session
    • Track: Surgery
    • Presentations: 1
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      O13.07 - Preoperative Predictive Factors of Nodal Metastasis in Patients with cT1 Lung Cancer (ID 3493)

      11:35 - 11:45  |  Author(s): L. Ren

      • Abstract
      • Presentation
      • Slides

      Background
      Lung cancer with small nodules(≤3cm) have less tendency of local regional lymph node metastasis. We investigate the value of preoperative clinicopathological characteristics in predict regional lymph node metastasis of cT1 lung cancer patients.

      Methods
      A retrospective review of database identified 384 patients with cT1N0M0 lung cancer, diagnosed by CT/PET-CT/MRI and pathologically confirmed as primary lung cancer. All the patients underwent surgery (include sublobar resection, lobectomy and pnemonectomy) and systemic mediastinal lymphadenctomy, and receive no preoperative chemotherapy or radiotherapy. The correlation between clinicopathological factors and the nodal status was analyzed by logistic regression model.

      Results
      The prevalence of lymph node metastasis is 69/384 (18.0%) . Univariate analysis identified tumour size, elevated CEA level and Standar uptake value(SUV)≥2.5 affect nodal status. Shown in Table1. In multivariate analysis, only tumour size (≤1cm vs >1-≤2cm vs >2-≤3cm，P=0.000) was found to be independent predictors of nodal metastasis. Shown in Table 2.Figure 1Figure 2

      Conclusion
      Tumour size is the only predictive factor of nodal metastasis for patients with cT1 lung cancer. Futher invastigation is recommend in omission of mediastinal lymphadenctomy in cT1 patients with tumour size of <2cm and SUVmax<2.5.

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    P2.12 - Poster Session 2 - NSCLC Early Stage (ID 205)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.12-016 - Predict foctors of lymphatics metastasis or early distant and regional failure after complete resection in cT1 lung adenocarcinoma (ID 2116)

      09:30 - 09:30  |  Author(s): L. Ren

      • Abstract

      Background
      cT1 lung cancer presented as solitary pulmonary nodule(SPN) tends to be stage I disease. Nevertheless, early recurrences were observed in these patients. The purpose of this study is to identify clinicopathological factors associated with early failure in cT1 adenocarcinoma after complete resection.

      Methods
      Between Jan.2006 and Jun.2012, 419 cases of lung adenocarcinoma presented as SPN underwent completely resection in our hospital. Of which, we identify 216 cases that follow-up for more than 1-year and assigned to three group according to pN status and recurrence. Group A, 49 cases with pathological diagnosis of lymphatic metastasis; Group B, 23 pN0 cases with early recurrence; Group C, 144 pN0 cases have no recurrence or metastasis; Group D, combine Group A and B. All the pN0 patients in this study have not received adjuvant therapy. Chi-square test is used to analyze each factors’ difference. Multivariate logistic regression analysis was used to identify independent factors.

      Results
      Incidents of preoperative elevated CEA, Poorly differentiated of cancer cells, vascular invasion in Group A, B and D were significantly higher than those of Group C. Besides, tumor size >2cm were frequently observed in Group A(p＜0.001). And more males in group D than in group C. See Table-1. Tumor size, cancer cell differentiation and vascular invasion identified as independent factors by multivariate logistic analysis. . Figure 1

      Conclusion
      cT1pN0 Stage I lung adeocarinoma patients with male, preoperative elevated CEA, poorly differentiated cancer cells, vascular invasion were associated with early failure. Adjuvant therapy in patients with these factors need further study.

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    P2.19 - Poster Session 2 - Imaging (ID 180)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      P2.19-009 - A Prediction Model to Estimate the Probability of Malignancy of Solitary Pulmonary Nodules Intergrating PET-CT and Clinical Data. (ID 1278)

      09:30 - 09:30  |  Author(s): L. Ren

      • Abstract

      Background
      Most solitary pulmonary nodules(SPN) discovered by CT scan are benign. 18F-FDG PET has been reported better differentiated benign from malignant pulmonary nodules. Three previous developed clinical prediction models (Mayo model,VA model and Peking University model) are based on CT scan. We intergrating PET-CT and Clinical Data to increase accuracy in estimate the probability of malignancy of SPN.

      Methods
      From January 2009 to December 2012, 365 consecutive patients diagnosed SPN by PET-CT have been identified and reviewed. Clinical data were collected retrospectively. The data set was split into two groups: training set (305 patients) and testing set (60 patients). Independent factors associated with benign and malignancies were identified using training set by logistic regression analysis, and a prediction model has been established. Patients from the testing set were then used to validate the predictive value of this model, and compared accuracy with Mayo model and Peking University model.

      Results
      Logistic analysis showed three clinical characteristics(gender,age, smoking data) and six radiological characteristics(diameter, upper lobe,speculation, lobulation, pleural tail, FDG uptake) were independent predictors for malignancy. The area under the evaluated receiver operating characteristics curve was 0.854±0.043. Compared to Mayo model,VA model and Peking University model, this PET-CT based model showed better predictive value. Figure 1

      Conclusion
      Our PET-CT based clinical prediction model has better accuracy in estimate the pretest probability of malignancy in patients with SPNs.