초록접수 현황
| 15F-022 | 포스터 발표 |
Prognostic Value of SUVmax and Invasive Size Ratio in Stage IA Adenocarcinoma
이은주, 신경욱, 장효준, 김관민, 전상훈, 조석기
서울대학교 의과대학 분당서울대학교병원 흉부외과학교실
Background : Lung adenocarcarcinoma comprises heterogenous histologic groups. Diverse characteristics such as histologic subtypes, maximum standardized uptake value (SUVmax), and invasive tumor sizes are well known important prognostic factors. Evaluation of prognostic factor is important, for lung adenocarcinoma reveals higher rates of recurrences even in early stages. The aim of this study is to investigate convenient prognostic index for early stage lung adenocarcinoma to evaluate the high risk groups of recurrence.
Methods : Between 2003 and 2013, a total of 1277 patients of lung adenocarcinomas underwent surgical treatments, and stage IA comprised 755 patients. Exclusion criteria were as follows; (1) tumors with lepidic components only, (2) patients with neoadjuvant therapy, and (3) patients with insufficient data. Medical records of enrolled patients were reviewed retrospectively. We calculated the index of SUV max and invasive tumor ratio as following formula; SUVmax X (invasive tumor size/total tumor size). The median Enrolled patients were categorized into two groups. Group 1 consisted of the patients with index of SUV max and invasive tumor size ratio less than the median. Group 2 comprised the rests. Clinicopathologic characteristics were compared and survival analysis was done.
Results : The number of enrolled patients were 381 (182 men and 199 women). The mean age was 63.1 (±9.92), and the mean follow-up periods were 51.1 months (±29.7). In univariate analysis, gender, SUV max value, histologic subtypes, total tumor size, and invasive tumor size were statistically significant risk factors. However, only SUVmax and invasive tumor size were independent risk factors for recurrence in multivariate analysis. (p<0.000, and p=0.045 respectively). In receiver Operating Characteristic (ROC) Curve analysis, the area under the curve (AUC) value of SUVmax, invasive tumor size, and the index of SUVmax and invasive tumor size ratio were 0.803, 0.703 and 0.811 respectively. The median of index of SUVmax and invasive tumor size ratio was 1.4. Group 1 (Index<1.4) comprised 189 patients, and Group 2 (Index ≥ 1.4) 192 patients. In survival analysis, 5-year overall survival and recurrence-free survival rates of Group 1 were 98.4% and 97.8% respectively. Those of Group 2 were 83.8% and 78.6% respectively. The 5-year overall and recurrence free survival rates between the two groups showed statistically significant differences (p<0.000, both). In cox-regression hazard analysis, the recurrence hazard ratio of Group 2 was 16.3 (p<0.000).
Conclusion : The index of SUVmax and invasive tumor size ratio can reflect the prognosis of stage IA lung adenocarcinomas. Risk for recurrence in patients with index value more than 1.4 estimated 5 times larger than those who with index value less than 1.4. Patients with more than 1.4 of index value should be carefully followed detecting recurrence even they belong to early stage lung cancer.
Methods : Between 2003 and 2013, a total of 1277 patients of lung adenocarcinomas underwent surgical treatments, and stage IA comprised 755 patients. Exclusion criteria were as follows; (1) tumors with lepidic components only, (2) patients with neoadjuvant therapy, and (3) patients with insufficient data. Medical records of enrolled patients were reviewed retrospectively. We calculated the index of SUV max and invasive tumor ratio as following formula; SUVmax X (invasive tumor size/total tumor size). The median Enrolled patients were categorized into two groups. Group 1 consisted of the patients with index of SUV max and invasive tumor size ratio less than the median. Group 2 comprised the rests. Clinicopathologic characteristics were compared and survival analysis was done.
Results : The number of enrolled patients were 381 (182 men and 199 women). The mean age was 63.1 (±9.92), and the mean follow-up periods were 51.1 months (±29.7). In univariate analysis, gender, SUV max value, histologic subtypes, total tumor size, and invasive tumor size were statistically significant risk factors. However, only SUVmax and invasive tumor size were independent risk factors for recurrence in multivariate analysis. (p<0.000, and p=0.045 respectively). In receiver Operating Characteristic (ROC) Curve analysis, the area under the curve (AUC) value of SUVmax, invasive tumor size, and the index of SUVmax and invasive tumor size ratio were 0.803, 0.703 and 0.811 respectively. The median of index of SUVmax and invasive tumor size ratio was 1.4. Group 1 (Index<1.4) comprised 189 patients, and Group 2 (Index ≥ 1.4) 192 patients. In survival analysis, 5-year overall survival and recurrence-free survival rates of Group 1 were 98.4% and 97.8% respectively. Those of Group 2 were 83.8% and 78.6% respectively. The 5-year overall and recurrence free survival rates between the two groups showed statistically significant differences (p<0.000, both). In cox-regression hazard analysis, the recurrence hazard ratio of Group 2 was 16.3 (p<0.000).
Conclusion : The index of SUVmax and invasive tumor size ratio can reflect the prognosis of stage IA lung adenocarcinomas. Risk for recurrence in patients with index value more than 1.4 estimated 5 times larger than those who with index value less than 1.4. Patients with more than 1.4 of index value should be carefully followed detecting recurrence even they belong to early stage lung cancer.
책임저자: 조석기
서울대학교 의과대학 분당서울대학교병원 흉부외과학교실
연락처 : 이은주, Tel: 031-787-7146 , E-mail : viking99@hanmail.net
