Author of

• 20154

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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)

  • 22641

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    P1.05-019 - Effects of Tumor Stroma and Inflammation on Survival of Stage I-IIp Lung Cancer (ID 8443)

    09:30 - 09:30  |  Author(s): L. De Esteban Julvez
    • Abstract

    Background:
    In lung cancer (LC) TNM classification allows an estimation of patient prognosis, but a third of patients with initial stages will relapse within three years. Molecular markers may increase prognostic accuracy and identify subgroups with high risk of progression.
    
    Method:
    Stromal (fibrous stroma and α-actin) and inflammation markers (IL1β, TNF-α and COX-2) were examined by immunohistochemistry in tumor tissue from a cohort of 222 patients with early-stage (I-IIp) LC recruited in Spain for the International Association for the Study of Lung Cancer TNM-16 staging project.
    
    Result:
    The diagnosis was non-small cell lung carcinoma (NSCLC) in 199 patients (106 adenocarcinoma and 93 squamous cell carcinoma) who were the target for this study. The participants had a mean age of 69 (SD 9) years, frequent respiratory (108, 54.3%) and cardiac (84, 42.2%) comorbidities, and were staged as IA (53, 26.5%); IB (56, 28.1%); IIA (41, 20.6%); IIB (40, 20.1%) or ≥III (9, 4.5%). After three years 94 patients had died (47.2%). In the bivariate analysis, 3-year mortality showed statistically significant associations with more advanced stage (p <0.001) and a higher proportion of fibrous stroma in the tumor (p = 0.014); and a marginal relationship with cardiac comorbidity (p= 0.07) and higher IL1β levels (p = 0.098). Sensitivity and specificity of fibrous stroma and IL1β were calculated and optimal cut-off points established according to Youden’s index. Using these cut-offs, fibrous stroma in >8% of the tumor sample and IL1β H-score levels above 1356 were significantly related to mortality. In Cox proportional hazards models, adjusting by stage and cardiac morbidity, patients with fibrous stroma levels above 8% had higher 3 year-mortality [HR= 2.03, 95% CI (1.1-3.7), p= 0.021]; and similar results were obtained in patients with IL1β levels above 1356 [HR= 2.05, 95% CI (1.1-3.7), p= 0.019]. Combining both markers, patients with both markers above their established cut-offs had a significantly higher risk of 3 year mortality [HR= 2.95% CI (1.1-3.6), p= 0.022].
    
    Conclusion:
    An overrepresentation of fibrous stroma and IL1β in the tumor sample is independently associated with 3 year mortality in NSCLC, confirming that the tumor stroma influences survival in LC. Funded by PII Oncology SEPAR and FIS 12-02040