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S. Jiang



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    P3.12 - Poster Session 3 - NSCLC Early Stage (ID 206)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P3.12-010 - Impact of parietal pleural invasion at adhesion sites of lung cancers and implications for prognosis in the 7th TNM classification (ID 2160)

      09:30 - 09:30  |  Author(s): S. Jiang

      • Abstract

      Background
      In the 7th tumor, node, metastasis (TNM) classification or lung tumors, visceral pleural invasion (VPI) of lung cancers is defined as invasion beyond the elastic layer, including invasion to the visceral pleural surface, and T1 tumors with VPI are upgraded to T2a. Recently, we demonstrated that the microscopic invasion beyond elastic fibers of the visceral pleura but no penetration to the parietal pleura at tight adhesion sites (we term this p1-3) should be managed as a T2 disease in the 6th edition (Virchows Arch. 2005; 447: 984-9). Thus, this study investigated the prognostic value of p1-3 invasion in the current 7th TNM classification.

      Methods
      Between 2000 and 2012, 976 consecutive patients with non-small cell lung cancers (NSCLCs) underwent curative surgical resection at the Kitasato University Hospital. Staging definitions for T, N, and M components were according to the 7th International Staging System for Lung Cancer. Twenty two patients (2.3%) with p1–3 pleural invasion were included. These patients were studied clinically and pathologically in comparison with cases treated during the same period. To maximize the power of assessing prognostic potential, we set the significance level at 0.10, one-sided.

      Results
      The p1–3 condition sites of the 22 cases were the parietal pleura for all cases. The 5-year overall survival (OS) rate for these p1–3 patients was 62%. No significant differences were observed among p1–3, IB, IIA or IIB groups (p=0.185). However, the 5-year OS curve of p1-3 and N0 group (n=15) was similar to that of N0 and IIB disease.

      Conclusion
      Our results indicate that p1–3 patients can be managed as having a T3 (PL3) disease for the present classification, and that in such cases, complete tumor removal could improve the long-term survival. Because of the small number of patients available for this analysis, a large-scale and nationwide study is warranted for validation of p1–3 status as a T3 (PL3) disease for NSCLCs.