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Y. Yang
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-023 - Intrapulmonary Lymph Node Metastasis of Non-Small Cell Lung Cancer: Distribution Pattern and Therapeutic Relevance (ID 8687)
09:30 - 09:30 | Author(s): Y. Yang
- Abstract
Background:
Intrapulmonary lymph node retrieval is important for pathological staging and omitting this procedure may affect the outcome evaluation for patients of pN0. In this study, we aim to investigate the incidence and distribution pattern of intrapulmonary nodes involvement (level 13-14) in a pathological N1 cohort. Meanwhile, survival benefit of adjuvant chemotherapy for patients with N1 nodes involvement only limited in intrapulmonary levels was explored.
Method:
From January 2006 to December 2014, 1979 cases admitted to Peking University Cancer Hospital were treated with standard lung resection and systematic lymph node dissection and intrapulmonary lymph nodes retrieval, of which 160 cases of pathological N1 status entered the analysis. Surgeons collected intrapulmonary nodes after operation according to the protocol and all samples were sent for pathological examination. The data was prospectively collected and retrospectively analyzed. For those with N1 nodes involvement only limited in intrapulmonary levels, adjuvant chemotherapy was suggested by oncologists and patients may or may not follow the advice due to insufficient evidence in this condition. The outcome of those receiving adjuvant chemotherapy and those not was compared.
Result:
In this group, 104 cases (65%) reported level 13-14 nodes metastasis and 57 cases (36%) of N1 spreading only limited in level 13-14. The average levels and numbers of intrapulmonary node involvement were 1.09±0.29 and 1.54±0.85, respectively. For peripheral lung cancer, 38 of 89 cases (42.7%) showed non-tumor-located level 13-14 metastasis. Level 13-14 involvement in non-tumor-bearing segment of the right upper lobe was more frequent than that of the lower lobe (44.4% vs 13.3%, p=0.032), but this trend didn't occur in the left side(56.5% vs 45.8%, p=0.464). In 25 cases with tumor diameter ≤ 2cm, 13 cases (52%) presented non-tumor-bear segment metastasis(right side 38.5% vs left side 52.0%). Among 57 cases of pN1(13-14 only), 38 cases showed all three stations' collection and examination from level 10 to 12 in pathological reports, of which 19 had adjuvant chemotherapy and remaining 19 did not. Survival analysis in this 38 cases revealed survival benefit for patients receiving adjuvant chemotherapy (5-year OS 100% vs. 73.7%±11.6%, p = 0.043; 5-year DFS 53.9%±12.8% vs. 74.6%±8.5%, p=0.563).
Conclusion:
High incidence of intrapulmonary node metastasis and frequent spreading to non-tumor-located (sub)segments in pN1 group may indicate the clinical relevance of intrapulmonary node retrieval. The oncological outcome may be improved by adjuvant chemotherapy for those with N1 nodes involvement only limited in intrapulmonary levels.
