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H. Onoda
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P1.05 - Early Stage NSCLC (ID 691)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.05-003 - Impact of Coexisting Pulmonary Diseases on Oncological Outcomes of Patients with pStage I Non-Small Cell Lung Cancer (ID 7923)
09:30 - 09:30 | Author(s): H. Onoda
- Abstract
Background:
Cigarette smoking is a well-known cause of interstitial lung diseases (ILDs), pulmonary emphysema, and lung cancer. Coexisting pulmonary diseases can affect outcomes of patients with early-stage lung cancer. The aim of this study was to analyze the influence of pulmonary diseases upon oncological outcomes of patients with smoking history who underwent surgery for pStage I non-small cell lung cancer (NSCLC).
Method:
Medical records of a total of 227 patients with smoking history (current/former) who underwent anatomical lung resections (200 lobectomies and 27 segmentectomies) for pStage I NSCLC between June 2009 and December 2014 were reviewed. Coexisting ILDs were evaluated on high-resolution computed-tomography (HRCT). The degree of pulmonary emphysema was determined using image analysis software, applying Goddard classification. The impact of clinicopathologic factors including pulmonary diseases on oncological outcome was evaluated.
Result:
Among the 227 patients, ILDs on HRCT were detected in 47 (20.7%) patients; of those, UIP pattern and non-UIP pattern were seen in 19 (8.4%) and 28 (12.3%) patients, respectively. The degree of pulmonary emphysema was classified into normal, mild and moderate, including 44 (19.4%), 146 (64.3%) and 37 (16.3%) patients, respectively. Pathological stages were IA in 131 patients and IB in 96. The 5-year overall survival (OS) and cancer-specific survival (CSS) were 81.2% and 88.2%, respectively. Univariate analysis showed that UIP-pattern on HRCT, moderate pulmonary emphysema, vascular invasion, visceral pleural invasion (VPI), and pStage IB were correlated with poor CSS. Cox proportional hazards models revealed that the presence of UIP-pattern and VPI were independent risk factors for poor CSS. During a median follow-up period of 42.7 months, recurrent diseases were seen in 41 (18.1%) patients. Multiple logistic regression analysis showed that the presence of UIP-pattern and VPI were significantly related with tumor recurrence.
Conclusion:
The coexistence of UIP-pattern ILD on HRCT was shown to negatively affect the oncological outcome of patients with smoking history who underwent surgery for pStage I NSCLC.
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P3.13 - Radiology/Staging/Screening (ID 729)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.13-013 - Association of Pleural Tags with Visceral Pleural Invasion of Peripheral Lung Cancer (ID 8716)
09:30 - 09:30 | Author(s): H. Onoda
- Abstract
Background:
Visceral pleural invasion (VPI) is an important prognostic factor for patients with peripheral lung cancer, but its accurate preoperative evaluation with CT is difficult. Pleural tags, which are defined as one or more linear strands that extend from the tumor surface to the pleura, are sometimes seen in peripheral lung cancer that does not abut the pleura. However, studies evaluating the correlation of pleural tags with VPI are limited. The aim of this study was to evaluate the association of pleural tags with VPI of peripheral lung cancer, especially focusing on the type of pleural tags.
Method:
A total of 183 patients were retrospectively analyzed. They underwent pulmonary resection in our hospital between January 2009 and December 2015 for peripheral lung cancer ≦2 cm in solid tumor diameter and dose not abut the pleura. Forms of pleural tag were classified as follows; linear tag, linear tag with soft tissue component at the pleural end, and soft tissue cord-like tag. The relationships between VPI and clinical factors including the forms of pleural tag were analyzed using chi-square for independence tests, and then multivariate logistic regression models were applied.
Result:
Histologically, 23 (12.6%) patients were proven to have VPI. Overlap and multiple forms of pleural tags were frequently seen. Multivariate analysis revealed that tumors with linear tag with soft tissue component at the pleural end had significant association with VPI (p = 0.008). Sensitivity and specificity were 47.8% and 83.8%, respectively, in the prediction of VPI with this type of pleural tag. Presence of multiple linear tags also was associated with VPI (p = 0.036).
Conclusion:
Specific forms of pleural tag can predict VPI of peripheral lung cancer ≦2 cm in solid tumor diameter and dose not abut the pleura.
