초록접수 현황
| 15F-207 | 구연 발표 |
Patterns of Postoperative Recurrence in Pathologic Stage I
Lung Adenocarcinoma with Visceral Pleural Invasion
Tio Dhihintia, Sukki Cho, Kwhanmien Kim, Sanghoon Jheon
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
Background : Visceral pleural invasion (VPI) is well known to be a poor prognostic factor and pleural seeding is one of recurrence patterns after curative resection for non-small cell lung cancer. This study was to evaluate the patterns of recurrence in pathologic stage I lung adenocarcinoma with VPI after curative resection.
Methods : Among 574 patients with pathologic stage I lung adenocarcinoma after complete resection between 2003 and 2012, the clinicopathologic characteristics of 89 patients (15.5%) who had recurrence were retrospectively reviewed. The pathologic findings, post-recurrence survival, and patterns of recurrence were compared between patients with VPI and without VPI. The VPI was evaluated with the use of H & E stained slides and was defined as tumor extension beyond the elastic layer of the visceral pleura. The comparison was also between PL1 and PL2 in group 1 ( VPI ).
Results : Median follow-up duration was 53.6 months. The VPI was found in 43 patients (group I) and not in 46 patients (group II). VPI was divided in PL1 (23 patients), PL2 ( 14 patients), and NA / not available ( 6 patients ). Both sizes of total tumor and invasiveness were bigger in group I (3.2 vs 2.7 cm, 2.5 vs. 2.1cm, p<0.05). The median duration of overall survival was 58 months in group I and 76 months in group II. As patterns of recurrence, pleural seeding was found in 25 patients, and the percentage of pleural seeding was significantly higher in group I than group II (44.2% vs. 13.0%, p=0.001). But there is no significantly difference for pleural seeding between PL1 and PL2 ( 47% vs 42%, p=0.3 ). In group I, bilateral lung metastasis was significantly common (39.5% vs. 13.0%, p=0.004), and increasing percentage of pleural seeding was observed as the invasive tumor size grows (20% in T1a, 36% in T1b, and 44% in T2a). There is no significantly difference for bilateral lung metastasis between PL1 and PL2 ( 35% vs 47%, p=0.06)
Conclusion : The presence of VPI was a significant predictable factor for pleural seeding and bilateral lung metastasis as patterns of recurrence after complete resection in pathologic stage I lung adenocarcinoma. However, there is no significantly difference between PL1 and PL2. This result might provide an evidence of the needs of the intraoperative pleural lavage cytology in lung cancer with suspicious VPI.
Methods : Among 574 patients with pathologic stage I lung adenocarcinoma after complete resection between 2003 and 2012, the clinicopathologic characteristics of 89 patients (15.5%) who had recurrence were retrospectively reviewed. The pathologic findings, post-recurrence survival, and patterns of recurrence were compared between patients with VPI and without VPI. The VPI was evaluated with the use of H & E stained slides and was defined as tumor extension beyond the elastic layer of the visceral pleura. The comparison was also between PL1 and PL2 in group 1 ( VPI ).
Results : Median follow-up duration was 53.6 months. The VPI was found in 43 patients (group I) and not in 46 patients (group II). VPI was divided in PL1 (23 patients), PL2 ( 14 patients), and NA / not available ( 6 patients ). Both sizes of total tumor and invasiveness were bigger in group I (3.2 vs 2.7 cm, 2.5 vs. 2.1cm, p<0.05). The median duration of overall survival was 58 months in group I and 76 months in group II. As patterns of recurrence, pleural seeding was found in 25 patients, and the percentage of pleural seeding was significantly higher in group I than group II (44.2% vs. 13.0%, p=0.001). But there is no significantly difference for pleural seeding between PL1 and PL2 ( 47% vs 42%, p=0.3 ). In group I, bilateral lung metastasis was significantly common (39.5% vs. 13.0%, p=0.004), and increasing percentage of pleural seeding was observed as the invasive tumor size grows (20% in T1a, 36% in T1b, and 44% in T2a). There is no significantly difference for bilateral lung metastasis between PL1 and PL2 ( 35% vs 47%, p=0.06)
Conclusion : The presence of VPI was a significant predictable factor for pleural seeding and bilateral lung metastasis as patterns of recurrence after complete resection in pathologic stage I lung adenocarcinoma. However, there is no significantly difference between PL1 and PL2. This result might provide an evidence of the needs of the intraoperative pleural lavage cytology in lung cancer with suspicious VPI.
책임저자: Sukki Cho
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
연락처 : Tio Dhihintia, Tel: 031-787-7140 , E-mail : psj324@hanmail.net
