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I. Kotteas
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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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P1.05-074 - Factors Predicting Discordance between Clinical and Surgical-Pathologic Staging in Operable Non-Small Cell Lung Cancer (ID 4083)
14:30 - 14:30 | Author(s): I. Kotteas
- Abstract
Background:
Accurate clinical staging is of the utmost importance for the optimal management of patients with non-small cell lung cancer (NSCLC). The aim of this study was to identify factors associated with discordance between clinical and pathologic staging in patients with operable NSCLC.
Methods:
The medical records of 85 patients with early-stage NSCLC, who had been submitted to thoracotomy followed by surgical resection of the primary tumor and systematic lymph node dissection, were retrospectively reviewed. All patients were staged according to the 7th edition of the TNM staging system. The presence of postoperative upstaging or downstaging was correlated with various demographic and clinicopathological factors, including age, sex, smoking history, tumor histology, tumor size and location.
Results:
Discordance between clinical and surgical-pathologic staging was found in 45/85 cases (52.9%), and the majority of these patients were upstaged (35/85 cases, 41.2%). Patients with IIB and IB clinical stage had the highest (77.8%) and lowest (48.1%) probability of discordance, respectively. With regard to T stage, disagreement between clinical and surgical-pathologic T stage was noted in 22/85 patients (25.9%), including 16 upstaged patients (16/85, 18.8%) and 6 downstaged patients (6/85, 7.1%). Nodal status was altered postoperatively in 39/85 cases (45.9%), including 29 upstaged patients (29/85, 34.1%) and 10 downstaged patients (10/85, 11.8%). The rate of unsuspected mediastinal lymph node involvement (pathologic stage N2) was 14.1% (12/85 patients), despite negative mediastinoscopy findings. Age was the only statistically significant factor independently associated with staging discordance (odds ratio 0.93; 95% confidence interval, 0.87 to 0.99).
Conclusion:
Postoperative upstaging or downstaging was observed in a relatively high percentage of our patient population, and was significantly and independently correlated with patient’s age. These observations warrant confirmation in larger prospective series of patients with early-stage NSCLC.
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-019 - TTF-1 Expression as a Predictor of Response to EGFR-TKIs in Patients with Lung Adenocarcinoma (ID 4033)
14:30 - 14:30 | Author(s): I. Kotteas
- Abstract
Background:
Several studies have shown that overexpression of thyroid transcription factor (TTF-1) may be associated with the presence of epidermal growth factor receptor (EGFR) gene mutations and predict survival in patients with non-small cell lung cancer (NSCLC). Nevertheless, the potential significance of TTF-1 immunostaining as a predictor of response to EGFR tyrosine kinase inhibitors (TKIs) has received limited research attention thus far. The aim of this study was to further explore the potential association between TTF-1 immunohistochemical expression and response to EGFR TKIs in patients with lung adenocarcinoma.
Methods:
The medical records of 129 patients with stage IV lung adenocarcinoma, treated at the Oncology Unit of “Sotiria” Athens General Hospital between January 2011 and December 2014, were retrospectively reviewed. All patients had received treatment with EGFR TKIs (erlotinib or gefitinib) and had a known TTF-1 immunohistochemical expression status in formalin-fixed, paraffin-embedded tumour tissue. Demographic and clinicopathological features (age, gender, smoking status and performance status), TTF-1 immunohistochemistry and EGFR mutation status results were correlated to each other as well as with the response rate (RR) to EGFR TKIs, using univariate and multivariate regression analysis.
Results:
Median age of our study population was 68 years (range 26-88 years), while the majority were male (79/129 cases, 61.2%). Patients with EGFR mutant tumors had significantly higher response rates to EGFR TKIs compared to patients with wild-type EGFR tumors (p=0.001). TTF-1 positive staining was weakly associated with the presence of EGFR mutations, without reaching the level of statistical significance (p=0.053). Most importantly, TTF-1 positive staining was not significantly correlated with RR to EGFR TKIs, when gender, age, smoking status, EGFR mutation status and PS were included in the multivariate model.
Conclusion:
The present results failed to demonstrate any independent association between TTF-1 overexpression and the RR to EGFR TKIs in patients with advanced-stage lung adenocarcinoma. Prospective data from larger cohorts of patients are needed to clarify the exact predictive value of TTF-1 immunostaining in this setting.
