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J. Maeda
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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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P1.08-034 - Prognostic Impact of EGFR Mutation in Patients with Surgically Resected Lung Adenocarcinoma; Analysis about Subtypes of EGFR Mutations (ID 6031)
14:30 - 14:30 | Author(s): J. Maeda
- Abstract
Background:
Epidermal growth factor receptor (EGFR) gene mutations have an important role for predicting the prognosis in advanced or recurrent lung cancer patients. However, the significance of EGFR mutation as a prognostic factor for survival after complete resection remains controversial. The aim of this study is to evaluate the impact of mutational status in patients with surgically resected lung adenocarcinoma.
Methods:
We retrospectively investigated the data of 414 patients (pts) with p-stage I-IIIA adenocarcinoma who underwent completely tumor resection in our hospital from 2009 to 2013. Overall survival (OS), disease-free survival (DFS) , and clinico-pathological factors affecting these factors were evaluated.
Results:
There were 202 males and 212 females (median age, 67 years). In total, 270 (65%), 66 (16%) and 78 pts (19%) had p-stageI, II and IIIA disease respectively. In all 210 pts (51%) with EGFR mutation were detected. Eighty-six pts (21%) had exon 19 deletion (19 del) and 113 pts (27%), exon 21 mutation (L858R). Among 414 pts, 131 pts (31%) had lung cancer recurrence. The median follow-up period was 38.6 months. p-stageI mutant/wild:145/125, II:24/42, and IIIA:41/37. The 3-year survival rates of p-I-II and IIIA mutant/wild were 96.8%/92.1% and 81.6%/61.8% respectively. The median survival time of p-stageIIIA mutant was 80.5 months, and those of others were not reached. The 3-year DFS of p-I-II and IIIA mutant/wild were 78.3%/69.2% and 27.1%/45.1%, respectively. There were no significant difference in OS and DFS at each p-stage despite the EGFR mutational status. Compared to the wild type, the p-IIIA mutant group had a poor DFS. conversely, compared to wild type, the p-I mutant group showed a favorable DFS. According to the subtypes of EGFR mutation, there were no significant differences among EGFR subtypes, but pts with 19del tended to have the worst DFS. In subgroup analysis of 131 pts with recurrence, 3-year survival rate of p-I-II and IIIA mutant/wild were 92.0%/75.8% and 80.8%/45.6% respectively. Pts with p-IIIA mutant showed significantly favorable OS than those of wild type (p=0.014) as well as with p-I-II wild type. Although OS was not significantly different among the subtypes of EGFR mutation, pts with 19del showed statistically better prognosis than shown by the wild type (p=0.038).
Conclusion:
EGFR status was an independent prognostic factor in pts with surgically resected lung adenocarcinoma. Particularly, EGFR exon 19 deletion might be the strongest predictive factor of poor DFS and good OS in resected lung adenocarcinoma.
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P3.01 - Poster Session with Presenters Present (ID 469)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.01-028 - Comparison of Touch Imprint Cytology and Section Histopathology in the Diagnostic of the Small Peripheral Lung Tumors (ID 5997)
14:30 - 14:30 | Author(s): J. Maeda
- Abstract
Background:
There have been some reports on transbronchial biopsy (TBB) through endobronchial ultrasonography with a guide sheath (EBUS-GS) for diagnostic sampling of small-sized tumors which showing ground-glass opacity (GGO) on chest CT. However, technique such as EBUS-GS is limited in their ability to diagnose such small lung tumors. The discussion about the cytological features of small tumors with GGO in detail is necessary. We evaluated about the association of the cytological features with the histological examination using the surgically resected specimen. 140 patients, age between 23–86 years old, who showed clinical and radiological signs of peripheral lung tumors below 3.0cm in diameter, underwent surgical resection at our institution between 2013 and 2015.
Methods:
Imprints or touch preparation and squash smears preparation were prepared from the unfixed, fresh sample in 140 cases. Papanicolaou's stain was employed in all cases. To make the squash smears preparation, the slides are drawn apart away from each other, in the direction of the long axis of the slide. Tissue fragments taken from surgical specimen were fixed with 10% neutral buffered formalin and stained with hematoxylin and eosin (H&E).
Results:
By histological examination (in the 140 cases), the diagnostic of lung cancer was given with the establishing of the histological type. In 110 cases (78.6%) of the cases diagnosed as adenocarcinoma, in 21 cases (15%) squamous cell carcinoma, in 4cases (2.9%) was neuroendocrine tumors, and one case each of adenosquamous carcinoma, pleomorphic carcinoma and pleomorphic sarcoma. In 84 of the 110cases (76.3%), the result of imprint cytological examination was adenocarcinoma. In the 110 pathological diagnosed as adenocarcinoma cases, 52 patients (47.2%) are below 2.0cm in size. Tumor stamps of small sized adenocarcinoma are characterized by moderate cellularity and are composed of atypical cells arranged in small flat sheets. The nuclei are generally round, slightly hyperchromatic with small nucleoli.
Conclusion:
Our data indicate the fact that the cytological examination on stamps from surgical material offers a very high percentage of positive results, close to the histological one. But in the tumor size less than 1.0cm, the establishing of the histological type of lung cancer is more difficult by cytological examination. Despite this, the cytology may be extremely useful in diagnose of the small peripheral tumors. The cytological characteristics of small peripheral adenocarcinoma were little reference to the differentiation at the cellular level. Our findings indicated that the presence of several nucleoli and granular chromatin densely are the factors of adenocarcinoma.
