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C.H. Kang
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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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P1.05-007 - Analysis of RNA Sequencing Data along with PET SUV-max Can Discover Novel Gene Sets Which Can Predict Surgical Outcome of NSCLC (ID 5404)
14:30 - 14:30 | Author(s): C.H. Kang
- Abstract
Background:
Recent development of NGS technology provides a better understanding on the molecular mechanism of the cancer. A comprehensive analysis algorism of NGS data along with various clinical phenotypes and clinical outcome may lead discovery of novel molecular mechanism of cancer biology. It has been suggested that the preoperative SUV of the PET-CT is related to the aggressiveness of the cancer. We hypothesized that the identification of genes that were related to the PET SUV-max would lead a discovery of novel genes which could predict long-term outcomes of patients of non-small cell lung cancer.
Methods:
We set a 51 adenocarcinoma and a 101 squamous cell carcinoma patients cohort, whose cancer and normal tissue whole transcriptome sequencing data were available. The RNA sequencing fastq files were aligned on the reference genome (http://grch37.ensembl.org/) and the differential expressions were analyzed using tuxedo protocol (TopHat 2.0, Cufflinks 2.2.1). Visualizations of differential expressions were presented with CummeRbund R-package.
Results:
Based on the preoperative PET-CT SUV-max, patients were classified as "Low" (SUV≤3), "Intermediate" (SUV 3-10), and "High" (SUV>10) groups. Using the tuxedo RNA analysis tools, we selected 31 genes which showed significantly different expression of RNAs between "Low" and "High" groups in adenocarcinoma and between “Intermediate” and “High” groups in squamous cell carcinoma. By comparing expression levels of those 31 genes according to the development of recurrence, we could identify two sets of genes (COL2A1, BPIFB2, RYR2, F7, HPX, AC022596.6 and H19 for adenocarcinoma; BPIFB2, AC022596.6, ANKRD18B, GCLC, HHIPL2, COL2A1 and DPP10 for squamous cell carcinoma) which were related to the development of recurrence. Figure 1
Conclusion:
Our results suggest that it is necessary to set a comprehensive analysis algorithm of the NGS data along with various clinical phenotypes of the patients, for the discovery of clinically meaningful molecular mechanisms of the cancer.
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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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P2.04-001 - A Comparative Analysis of Long-Term Outcome of Thymoma between Video-Assisted Surgery and Open Resection from Multi-Center Study Data (ID 6297)
14:30 - 14:30 | Author(s): C.H. Kang
- Abstract
Background:
To compare the oncologic results between video-assisted thoracoscopic surgery and open resection in early and locally advanced thymomas from multi-center study database using propensity score matching analysis.
Methods:
Data from 1546 participants in the Korean Association for Research on the Thymus were used to analysis for video-assisted thoracoscopic surgery(VATS) versus open resection from January 2003 to December 2013. We performed propensity score matching analysis for the outcomes of video-assisted thoracoscopic surgery versus thoracotomy lung resection (based on age, gender, MG symptom, tumor size, WHO histologic type, receiving neoadjuvant chemotherapy).
Results:
We excised the thymoma using VATS in 513 patients, while 1033 patients underwent open procedures. There were not significant differences between the 2 groups for the 5-year overall survival (p=.61), recurrence-free survival (p=.25), and complete resection (p=.38). The operative times, the hospital stay duration, and the chest tube indwelling time were significantly shorter in the VATS group compared to in the open group. Median follow-up duration was 50.13 months (IQR 26.61-79.60). The Masaoka-Koga stage was I/II/III, IV in 556/604/384 patients, respectively. We analyzed on the basis of propensity score matching. There were no significant difference in survival rate (p=0.882/0.632/0.597), recur-free survival (p=0.120/0.104/0.488), and R0 resection (p=0.945/0.656/0.007) between 3 grups in multivariable analysis.
Conclusion:
Patients undergoing VATS thymectomy had shorter the operative time and the hospital stay duration. Moreover, survival rate and recurrence-free survival are equivalent between VATS and open resection. Therefore, video-assisted thoracosopic surgery is feasible approach for early and locally advanced stage thymoma.
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P3.04 - Poster Session with Presenters Present (ID 474)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.04-018 - Recurrence Dynamic of Completely Resected Non-Small Cell Lung Cancer in Perspective of Follow-Up Surveillance (ID 4850)
14:30 - 14:30 | Author(s): C.H. Kang
- Abstract
Background:
There is no clear evidence or consensus on the modality and frequency of follow-up surveillance after complete resection of non-small cell lung cancer (NSCLC). Understanding of recurrence dynamic is essential to establish more efficient surveillance strategy. We investigated recurrence dynamic in completely resected NSCLC to propose a reasonable surveillance strategy.
Methods:
A total of 950 patients who underwent complete resection of NSCLC from 2006 to 2009 were reviewed retrospectively. Clinic-pathological data including follow-up surveillance records were obtained. All patients were completely followed until October 2015. Pathologic stage I, II, and IIIa NSCLC were included in the analysis. Mode of detection and the chronological pattern of recurrence were analyzed.
Results:
The median follow-up duration was 72 months. Recurrences were detected in 259 patients (27.2%) and freedom-from-recurrence rates were 78.2% at 2 year and 69.9% at 5 year. Recurrence was detected by routine follow-up study in 227 (85.7%), and by symptoms in 32 (12.7%) patients. In 65.5% patients, recurrence was detected by computed tomography and 26.2% was detected by positron emission tomography. The median time-to-recurrence was 1.1 year in entire recurrence group. Median-time-to- recurrences were 1.5 year in stage I (106), 1.0 year in stage II (61), and 1.1 year in stage III (92). There was no significant difference in chronological trend between the three stages (p=0.26). The cumulative rates of recurrence were 41.7%, 73.8%, and 91.1% at the 1st, 2nd, and 3rd year. Chance of recurrence dropped below 5% after 3 years and the probability of detection of recurrence was 8.6%. (Fig.1) Figure 1
Conclusion:
Chronological patterns of recurrence of NSCLC does not different between stages and majority of recurrences were detected within postoperative second year. The probability of recurrence were significantly reduced after second year regardless of stage. Intensive surveillance until postoperative second year and less intensive surveillance from third year is a reasonable stratege.
