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H. Toba
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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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P1.03-030 - FDG-PET/CT Might Be a Predictor for Residual Disease in Advanced NSCLC after Chemoradiotherapy (ID 6299)
14:30 - 14:30 | Author(s): H. Toba
- Abstract
Background:
The standard treatment for locally advanced non-small-cell lung cancer (NSCLC) is chemoradiotherapy (CRT), some patients are considered for trimodality therapy represented by concurrent CRT followed by surgical resection. However, there is no validated clinical predictor for surgical resection after CRT. In the present study, we analyzed that the correlation between SUVmax of FDG-PET/CT in pre/post CRT and treatment effect.
Methods:
22 patients with advanced NSCLC underwent CRT in Tokushima University Hospital between February 2006 to March 2016. we reviewed the medical records of 22 patients to obtain information on age, gender, histological type, clinical stage, adverse events, reduction ratio of tumor, SUVmax of FDG-PET/CT in pre/post CRT. Radiographic response was assessed by Modified Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Toxicities were assessed according to the National Cancer Institute Common Toxicity Criteria (NCI-CTCAE).
Results:
Patient characteristics were as follows: average age of 65; male/female: 21/1, histologic type adenocarcinoma/squamous cell carcinoma/other: 14/5/3; clinical stage IB/IIB/IIIA: 1/3/18. Chemotherapy were platinum doublets regimen in almost cases. The average amounts of radiotherapy were 42Gy. The response rate was 29%. The number of PR/SD were 10/22 in RECIST. The adverse events were following: G2;11(50%), G3;8(36%), G4;5(23%). 2cases stopped treatment because of adverse events. Operative procedure were followings: lobectomy/bilobectomy/pneumonectomy: 17/2/3. The complication rate of operation was 27.2%, however, there was no hospital death. Overall survival was 69.7±10.3 months. Relapse free survival was 64.5±12.3 months. Pathological Complete Response(pCR) was recognized in 10cases(45.5%). The 4cases in 10cases of pCR got recurrence as distant metastasis, without local recurrence. The SUVmax decreasing rate was 69.8% in CRT. The SUVmax decreasing rate was 79% in the patients of pCR(n=5), however, this decreasing rate was 65% in not pCR(n=7, p=0.059). All cases of pCR indicated the SUVmax decreasing rate was more than 70%.
Conclusion:
The pCR were recognized in 10/22(45/5%) cases, underwent CRT. The treatment response in localregion was good in all cases. The SUVmax decreasing rate was more than 70% in all pCR cases.
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-005 - Stratification of pStage I Lung Adenocarcinoma by the Scoring System Based on Prognostic Factors (ID 5168)
14:30 - 14:30 | Author(s): H. Toba
- Abstract
Background:
In Stage I lung cancer, tumor size and PL factors are only reflected by the TNM staging system. However, other clinicopathological factors have the potential to influence recurrence and prognosis, especially in pStage I lung adenocarcinoma. This study aimed to evaluate prognostic factors, and to thereby stratify pStage I lung adenocarcinoma patients.
Methods:
A total of 203 patients who underwent curative resection for Stage I invasive adenocarcinoma, from 2006 to 2013, were retrospectively reviewed. [18]F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) was performed in 194 patients and the maximum standardized uptake value (SUVmax) of the tumor was calculated. Invasive adenocarcinoma was classified into 3 predominant subtypes (lepidic, papillary and others) according to the IASLC/ATS/ERS classification. The associations between various clinicopathological factors and recurrence were evaluated, and disease-free survival (DFS) was analyzed.
Results:
Twenty-eight patients had recurrent disease during the follow-up period (mean; 59.3±25 months). Univariable analysis showed male gender, smoking history >20 pack-years, BMI≦20, CEA>5ng/ml, T classification, tumor size>20mm, predominant histologic subtype (lepidic, papillary, others), pleural invasion, vascular invasion, and SUVmax>3.0 to be significantly associated with worse DFS. On multivariable analysis, tumor size>20mm (P=0.006), papillary predominant (P=0.023), other predominant (P=0.008), and SUVmax>3.0 (P=0.008) were extracted as independent prognostic factors associated with worse DFS. Predictive variables were scored as follows; tumor size>20mm (1 point), papillary predominant (1 point), other predominant (2 points) and SUVmax >3.0 (1 point). Patients were classified into 3 risk groups (low-risk; 0-2, intermediate-risk; 3, high-risk; 4) according to their aggregate scores. The 5-year DFS rate was 91% in the low-risk group, 55% in the intermediate group and 36% in the high-risk group. The 5-year DFS rates during the same period in our institute were 88% in pStage IA, 69.5% in pStage IB, 53% in pStage II, and 38% in pStage IIIA patients. Therefore, the DFS rate in the intermediate-risk group was comparable to that of pStage II, and the DFS rate in the high-risk group was comparable to that of pStage IIIA.
Conclusion:
In Stage I lung adenocarcinoma, tumor size, SUVmax and histologic subtypes were suggested to be prognostic factors. This scoring system may predict the groups, such as patients with pStage II and IIIA, requiring platinum based post-operative chemotherapy.
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P2.04 - Poster Session with Presenters Present (ID 466)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.04-052 - Promoter Hypermethylation of DNA Mismatch Repair Gene hMLH1 of Lung Cancer in Chromate-Exposed Workers (ID 6112)
14:30 - 14:30 | Author(s): H. Toba
- Abstract
Background:
Although it is known that chromium is an important inhaled carcinogen for lung cancer, there are few reports about genetic effects of chromium in oncogenic process. Our previous studies revealed that chromate lung cancer frequently had microsatellite instability (MSI), and that MSI was associated with the loss of expression of MLH1, which is one of the essential DNA mismatch repair proteins. Inactivation of MLH1 due to promoter methylation causes high level of microsatellite instability in hereditary nonpolyposis colorectal cancer (HNPCC). Therefore, we hypothesized that loss of expression of MLH1 in chromate lung cancer is caused by MLH1 promoter methylation similar to HNPCC. In the present study, we analyze DNA methylation of MLH1 promoter regions in chromate and non-chromate lung cancers and clarify whether methylation of MLH1 has the influence on MLH1 protein expression and MSI.
Methods:
Thirty-three tumor samples from chromate workers with lung cancer and thirteen tumor samples from lung cancer patients without chromate exposure (non-chromate group) were obtained. DNA was extracted from chromate and non-chromate lung cancer and bisulfite pyrosequencing was used to examine DNA methylation levels of MLH1 promoter regions. MSI, MLH1 protein expression of these tumor samples have been investigated in our previous studies.
Results:
High methylation levels of MLH1 promoter regions were found in 42.4% (7/33) of chromate lung cancers and 15.4% (2/13) of non-chromate lung cancers. Methylation rates of MLH1 promoter region and the grade of MSI were related to positive correlation in chromate lung cancers. Immunohistochemistry for MLH1 was performed in 24 chromate lung cancer, High methylation of MLH1 was found in 27.3% (3/11) of tumors with repression of MLH1 protein and 4.3% (1/13) of tumors with normal expression of MLH1 protein.
Conclusion:
According to the present data, DNA methylation of MLH1 promoter regions might contribute to loss of expression of MLH1 protein and MSI. We speculate that in addition to genetic changes, epigenetic events have emerged in chromium carcinogenesis.
