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M. Okada
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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.03-022 - Possibility of FDG-PET Predicting the Clinicopathological Characteristics and Prognosis of Lung Adenocarcinoma: Multicenter Study (ID 5799)
14:30 - 14:30 | Author(s): M. Okada
- Abstract
Background:
This multicenter study aimed to investigate the relationship of standardized uptake value (SUV) on [18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) and the clinicopathological characteristics of lung adenocarcinomas, and if it can be a predictor of prognosis of those patients.
Methods:
A total of 870 patients of adenocarcinoma patients received FDG-PET preoperatively and underwent curative resection with systematic lymph node dissection. The relationship among histological characteristics, pathological staging, prognosis, and SUV on FDG-PETmax was retrospectively examined.
Results:
The pathological stages of the cases were IA 526, IB 182, IIA 62, IIB 27, IIIA 67, IIIB 1, and IV 5, respectively. Pathological N1 (n = 60) and N2 (n = 58) cases showed a significantly higher SUVmax than N0 (n = 752) (9.15 ± 7.13 and 8.58 ± 6.14 vs 3.23 ± 4.16). Cases with pathological tumor invasiveness such as lymphatic, vascular or pleural infiltration showed a significantly higher SUVmax than cases with no invasiveness. (Ly negative; n=687, 2.76±3.59 vs Ly positive; n=183, 7.67±6.23, and v0; n=641, 2.18±2.58 vs v1 or 2; n=229, 8.30±6.23. p<0.001, respectively) The areas under the receiver operating characteristic curve for SUVmax used to predict the relapse-free survival was 2.9 (p < 0.001) in adenocarcinoma. The 3-year relapse-free survival was 97%/66% (SUVmax lower/ higher than 2.9) in adenocarcinoma. SUVmax was parallel to the aggressive nature based on histological subtypes (AIS +MIA; n=76, 0.51±0.58, Lepidic + Papillary + Acinar; n=686, 3.52±4.12, and Solid + Micropapillary; n=84, 8.52±6.67), which was statistically significant. (p<0.001 respectively)
Conclusion:
SUVmax of the primary tumor reflected the biological malignancy of lung adenocarcinomas. SUVmax is also useful for predicting pathological stage and prognosis. Multimodality treatment might be recommended in cases of high UVmax.
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-056 - Increased Risk of Postoperative Recurrence in EGFR-Positive Stage IA to IB Invasive Lung Adenocarcinoma (ID 4811)
14:30 - 14:30 | Author(s): M. Okada
- Abstract
Background:
Somatic mutations of EGFR represent one of the most frequent genetic aberrations in lung adenocarcinoma and response to tyrosine kinase inhibitors (TKIs) has been favourable in EGFR-positive and advanced lung adenocarcinoma patients. The prognostic significance of EGFR mutations as oncogenic driver mutations in early-stage lung adenocarcinoma has yet to be determined. We aimed to evaluate the oncological significance of EGFR mutations in early-stage lung adenocarcinoma
Methods:
Four hundred and seventy-three consecutive lung adenocarcinoma patients who underwent surgical resection for pathological N0M0 disease, between January 2007 and December 2013, were retrospectively reviewed. The prognostic significance of EGFR mutation status was evaluated in 407 cases from these patients. Overall survival (OS) and recurrence-free interval (RFI) curves were estimated using the Kaplan-Meier method and compared using a log-rank test. Univariate and multivariate analyses were performed using a Cox proportional hazards model.
Results:
There was no statistical significance in the 5-year OS (89.3 vs. 95.3%, P = .20, HR = 1.605) or RFI (86.5 vs. 93.5%, P = .06, HR = 1.956) rates between the EGFR-positive (n=183) and EGFR-negative (n=224) groups. Considering the risk of recurrence and positive EGFR mutation status, OS and RFI rates were subsequently calculated among specific histological subtypes. After adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive mucinous adenocarcinoma (IMA) cases were excluded, all analysed cases were ≤5.0 cm in tumour diameter and were classified as pathological Stage IA-IB. Among specific histological subtypes, the 5-year RFI (81.5 vs. 92.4%, P = .04, HR = 2.160) but not OS rate (86.8 vs. 94.3%, P = .31, HR = 1.499) was significantly poorer in EGFR-positive cases compared to EGFR-negative cases. Univariate analysis, excluding AIS, MIA, and IMA, identified a pathological tumour size of >3.0 cm, a highly malignant subtype (micropapillary or solid predominant adenocarcinoma), pleural/lymphatic/vascular invasion, and a positive EGFR mutation status as significant negative predictive factors for RFI. Multivariate analysis confirmed pleural invasion and a positive EGFR mutation status as independent negative predictive factors for RFI.
Conclusion:
EGFR mutation status is a predictive factor for postoperative recurrence in early-stage lung adenocarcinoma, with the exception of AIS, MIA, and IMA. The risk of recurrence should be considered with EGFR mutation status and predominant histological subtype in resected early-stage lung adenocarcinoma patients.
