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J.K. Park
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-015 - Prognostic Significance of Histologic Subtype in Stage I Non-Small Cell Lung Cancer (ID 2381)
09:30 - 09:30 | Author(s): J.K. Park
- Abstract
Background:
Non-small cell lung cancer consist of several histologic types. Among them, pulmonary adenocarcinoma has histologic heterogeneity. Current staging system relied on anatomical involvement of lung cancer. Histologic subtype has not been reflected in the TNM stage of lung cancer although there is some positive reports on prognostic factor. This study aimed to evaluate histologic difference as prognostic factor in stage I lung cancer.
Methods:
We retrospectively reviewed 269 patients with stage I adenocarcinoma and squamous cell carcinoma after curative pulmonary resection at single institute in Korea from August 2010 to December 2013. Adenocarcinoma was divided into 3 groups according to lepidic component; group 1(lepidic component ≥50%), group 2(lepidic component <50%), and group 3(no lepidic component). We compared these three groups with squamous cell carcinoma.
Results:
Mean tumor size of squamous cell carcinoma was larger than other three groups(2.8cm vs 1.9cm, 2.3cm, 1.9cm, p<0.001). There was no difference between group 3 and squamous cell carcinoma in the presence of pleural invasion(p=0.386) or vascular invasion(p=0.930), but lymphatic invasion was more frequent in squamous cell carcinoma(p=0.018)(Table 1). Three-year recurrence free survival of group 1, group 2, group 3 and squamous cell carcinoma were 98.5%, 86.8%, 74.3%, and 66.3%, respectively. (group 1 vs group 2, p=0.077; group 2 vs group 3, p=0.023; group 3 vs squamous cell carcinoma, p=0.907)(figure). Multivariate analysis showed that these 4 grouping was the statistically significant risk factor for the recurrence (HR 1.719, 95% confidence interval 1.051-2.811, p=0.031) Table 1. Clinicopathologic characteristics
Figure 1Group 1(n=74) Group 2(n=119) Group 3(n=36) Sqcc(n=40) p value Age 61.2(±9.2) 65.0(±10.0) 65.3(±10.0) 67.3(±1.7) 0.009 Female 45.9% 69.7% 25.0% 12.5% <0.001 Smoking history(pack years) 7.8(±14.7) 5.2 (±11.8) 20.8 (±22.9) 35.4 (±26.2) <0.001 Procedures Standard resection Limited resection 86.5% 13.5% 86.6% 13.4% 83.3% 16.7% 75.0% 25.0% 0.337 SUVmax 1.9 (±1.7) 3.8 (±3.3) 4.7 (±3.8) 10.0(±5.8) <0.001 Tumor size 1.9 (±0.8) 2.3 (±0.9) 1.9 (±0.6) 2.8(±1.0) <0.001 Number of dissected lymph nodes 12.7 (±7.6) 14.6 (±9.9) 11.1 (±8.1) 14.0 (±10.1) 0.181 Pleural invasion 6.8% 27.7% 25.7% 15.4% 0.003 Lymphatic invasion 13.5% 32.8% 25.7% 53.8% <0.001 Vascular invasion 1.4% 10.9% 14.3% 15.0% 0.037
Conclusion:
Among stage I adenocarcinoma, the prognosis of non lepidic component adenocarcinoma was poorer than lepidic adenocarcinoma. Although the malignant potential of squamous cell carcinoma was higher than adenocarcinoma in this study, the prognosis was not different between non lepidic component adenocarcinoma and squamous cell carcinoma. We expect these histologic prognosis factor will be considered in the new staging system.
