Author of

• 20177

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  P2.13 - Radiology/Staging/Screening (ID 714)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Radiology/Staging/Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23487

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    P2.13-018 - Clinical Outcomes Stage I/0 Adenocarcinoma Lung Diagnosed by Low Dose CT (LDCT) Screening vs Incidentally Discovered (ID 10298)

    09:30 - 09:30  |  Author(s): E. Burks
    • Abstract

    Background:
    Although LDCT lung screening has demonstrated improvement in overall survival, some have worried that indolent BAC-like adenocarcinomas (ADCA) may be over-detected/treated. We previously reported comprehensive and detailed pathologic comparison of stage I/0 lung ADCAs detected by LDCT screening vs incidentally discovered ADCAs stratified by NCCN risk criteria, demonstrating the presence of high grade invasive disease and high risk features in the LDCT group similar to incidentally discovered cancers. We now report clinical outcomes from a single institution LDCT program with associated pathology details.
    
    Method:
    Comprehensive histologic subtyping was performed on 54 consecutive stage I/0 LDCT screen detected ADCAs in patients meeting NCCN group 1/2 high risk (HR) criteria and compared to 77 incidentally detected stage I/0 ADCAs meeting HR criteria. We evaluated clinical outcomes in relation to details from pathologic evaluation.
    
    Result:
    We provide clinical data including disease free interval and recurrence in patients treated with curative intent for stage I adenocarcinoma detected by lung cancer screening vs incidentally discovered in HR patients with associated detailed pathologic evaluation. Screen detected and incidentally detected ADCAs show an equally low-rate of indolent, non-invasive/minimally invasive ADCAs. A collection of lepidic predominant (BAC-like) ADCAs associated with aggressive non-predominant cribriform and/or solid patterns and high proportion of lymphatic invasion were more frequently observed in the screen-detected group. Subgroup analysis of screen detected NCCN group 1 vs. 2 shows group 2 tumors exhibit histologic features which are at least as aggressive as group 1 tumors. Updated numbers with a larger cohort than previously reported and associated clinical data will be presented.
    
    Conclusion:
    We have demonstrated that many BAC-like tumors in LDCT screen detected patients bear histologic features of aggressive ADCAs, including among those still in a lepidic predominant phase. We provide the clinical data associated with updated numbers of the first detailed pathologic comparison of LDCT screen and incidentally detected ADCA of NCCN HR tumors.