Author of

• 12701

  +

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

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12719

    +

    P3.12-018 - Examination of the influence that vessel invasion gives prognosis of Stage I non small-cell lung cancer and the treatment effect of adjuvant therapy for the vessel invasion-positive Stage I cases (ID 3027)

    09:30 - 09:30  |  Author(s): K. Okubo
    • Abstract

    Background
    We suggested that vessel invasion may be an important recurrence factor of Stage I non small-cell lung cancer in the UICC-TNM 7th classification same as the previous classification in the 14th WCLC. On the basis of the result, we have performed postoperative adjuvant chemotherapy to the vessel invasion-positive patients who agreed to our informed consent as pilot study.

    Methods
    We reexamined the influence that vessel invasion gives prognosis of Stage I non small-cell lung cancer. We analyzed 279 Stage IA-IB cases to whom prognosis is clear and postoperative adjuvant therapy was not performed among 711 cases to whom radical operation was performed in Tokyo medical and Dental University Hospital in Nov.1993-Jun.2008. And we more weighed about prognosis 33 vessel invasion-positive Stage IA-IB cases to whom postoperative adjuvant therapy was performed in above Hospital and Musashino Red-Cross Hospital in May.2004 - April.2011 against 125 vessel invasion-positive cases (:no adjuvant group) among above 279 cases. We used Kaplan Meyer analysis for survival rate, the chi-square test for comparison of recurrence rate and Logistic regression analysis for multivariate analysis.

    Results
    In 279 cases, p-Stage IA and IB cases were 168 and 111. Five year survival rate was 93% and 72% in each stage (p<0.001). But in case vessel invasion is negative, there were not significant differences between p-Stage IA and IB (95% vs. 87%, p=0.16). On the other hand, in case vessel invasion is positive, there were significant differences (83% vs. 59%, p=0.01). Multivariate analysis of 279 cases showed that vessel invasion is the worst factor of death from recurrence (p<0.001) in tumor diameter, pleural invasion, differentiation, vessel invasion and lymphatic involvement. And it was revealed that the recurrence rate is high so that the degree of vessel invasion becomes higher (Recurrence rate: V0 6%, V1 14%, V2 33%; p<0.001. Five year survival: V0 93%, V1 68%, V2 66%; p<0.001). In 33 cases to whom adjuvant therapy was performed, an oral treatment of tegafur uracil was performed to 22 cases (:TU group), and platinum-based chemotherapy was performed to 11 cases (:PB group). Platinum-based chemotherapy was performed actively to the cases that the degree of vessel invasion is high (V2-3). In the cases the degree of vessel invasion is low (V1), four year survival rate and recurrence rate was 94% in TU group vs. 81% in no adjuvant group (p=0.09), and 4% vs. 20% (p=0.43). In the cases the degree of vessel invasion is high (V2-3), four year survival rate and recurrence rate was 91% in PB vs. 60% in TU vs. 64% in no adjuvant (p=0.13) and 10% vs. 40% vs. 36% (p=0.21).

    Conclusion
    It is supposed that vessel invasion may be an important prognostic factor of Stage I non small-cell lung cancer. Only the platinum-based chemotherapy may improve prognosis as adjuvant therapy for the Stage I cases in which the degree of vessel invasion is high though there were significant differences in this investigation because the number of the specimens was small. Therefore a large-scaled trial that will make this point clear should be planned.