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J. Cortsen
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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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P1.05-004 - Adenocarcinoma Subtyping of Early Stage Lung Cancer in a Danish Cohort (ID 9089)
09:30 - 09:30 | Author(s): J. Cortsen
- Abstract
Background:
The incidence of lung cancer in Denmark is approximately 4600/year. Adenocarcinoma is the most common histologic subtype, and standard treatment for early stage disease is radical surgical resection. According to the latest World Health Organisation (WHO) classification the histological subtyping of adenocarcinomas as well as visceral pleural invasion (VPI) are prognostic factors. Vascular invasion (VI) have also been associated with poor survival. This study aimed to validate the revised WHO classification on completely resected stage-I lung adenocarcinomas and investigate the prognostic significance of VPI and VI.
Method:
During a 9-year period (2004-2012) 367 consecutive patients with stage-I adenocarcinoma underwent surgical resection at a university based thoracic surgical centre. An average of 4 HE slides of tumour per case (range 2-10) were analysed microscopically by two dedicated pathology specialists. The predominant growth pattern was classified according to the revised WHO-classification and presences of subtypes. VPI and VI were included when evident from the primary pathology records and clinical data were retrieved from recorded electronic patient files. Survival was recorded from the National Civil Registry. We used a Cox proportional hazard regression model for all statistical analysis.
Result:
The 5-year overall survival (OS) for stage-I lung adenocarcinomas was 67%. Stratified by predominant histological subtypes univariate analysis showed OS was 72,7% for lepidic, 71,5% for acinar, 51,9% for papillary, 54,5% for solid, and 52,5% for micropapillary. However, multivariate analysis did not show any significant correlation between OS and predominant subtype (p=0.127). VI was highly predictive of OS (p=0.002) but VPI involvement was not (p=1,020). When analysing data for presence of subtypes we found that the papillary subtype was the only significant predictor (p=0.002). Age (p<0.001) and gender (p<0.001) were significant predictors for survival.
Conclusion:
Data from a consecutive Danish cohort of stage-I adenocarcinoma could not confirm the prognostic significance of the adenocarcinoma subtyping suggested by the WHO, but papillary subtype was associated with poor survival. Our data confirm that VI is a poor prognostic factor suggesting that VI should be included in the TNM classification.
