초록접수 현황
| 16F-099 | 구연 발표 |
Maximal Standardized Uptake Value on Positron Emission Tomography and Histologic Subtype are Prognostic Factors of Survival in Pathologic Stage Ⅰ Lung Adenocarcinoma.
Jung Hoon Yi, Sang Seok Jeong, Jae Hwa Jeong, Pil Jo Choi
Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
Background : Adenocarcinoma is the most common histologic subtype of lung cancer. Advances of diagnostic tools have resulted in increasing prevalence of early stage adenocarcinoma, however, predicting accurate prognosis of the disease remains difficult. This study aims to ascertain the prognostic values of readily available information before and after surgery, such as tumor markers, maximum standardized uptake value (SUVmax), and histomorphologic features.
Methods : We identified 132 patients from a surgical database who underwent resection of pathologic stage Ⅰ adenocarcinoma between January 2004 and August 2014. We investigated clinicopathologic characteristics including SUVmax, serum carcinoembryonic antigen, and predominant histologic subtype based on the 2015 World Health Organization classification. Predominant histologic subtypes were divided into three subgroups (lepidic[LEP] / acinar[ACN] and papillary[PAP] / micropapillary[MIP] and solid[SOL]), according to known grading system. Prognostic values for overall survival and recurrence-free survival were analyzed using Cox proportional hazard models.
Results : During follow-up, 34 deaths (25.8%) were occurred, and the median follow-up period was 51.5 months (mean: 56.6 months). 45 patients (34.1%) experienced recurrence, and the median recurrence-free period was 36.6 months (mean: 45.9 months). Univariate and multivariate analyses of overall survival indicated independent prognostic impact of age (hazard ratio[HR] 1.05; p=0.029), SUVmax (HR 2.23; p=0.041), and predominant histologic subtype grouping (LEP versus ACN/PAP HR 5.61; p=0.002, LEP versus MIP/SOL HR 5.59; p=0.009). In analyses of recurrence-free survival, SUVmax (HR 2.27; p=0.028) and sex (HR 2.67; p=0.012) were independent poor prognostic factors. Receiver operating characteristic curve analysis revealed that a optimal cut-off value of SUVmax for survival and recurrence was 4.66.
Conclusion : In patients with pathologic stage Ⅰ adenocarcinoma, SUVmax and predominant histologic subtype are independent prognostic factors, and SUVmax has significant adverse impact on recurrence, too. SUVmax and predominant histologic subtype are thought to be useful in determining the optimal therapeutic policy and in contributing to improving the postoperative prognosis.
Methods : We identified 132 patients from a surgical database who underwent resection of pathologic stage Ⅰ adenocarcinoma between January 2004 and August 2014. We investigated clinicopathologic characteristics including SUVmax, serum carcinoembryonic antigen, and predominant histologic subtype based on the 2015 World Health Organization classification. Predominant histologic subtypes were divided into three subgroups (lepidic[LEP] / acinar[ACN] and papillary[PAP] / micropapillary[MIP] and solid[SOL]), according to known grading system. Prognostic values for overall survival and recurrence-free survival were analyzed using Cox proportional hazard models.
Results : During follow-up, 34 deaths (25.8%) were occurred, and the median follow-up period was 51.5 months (mean: 56.6 months). 45 patients (34.1%) experienced recurrence, and the median recurrence-free period was 36.6 months (mean: 45.9 months). Univariate and multivariate analyses of overall survival indicated independent prognostic impact of age (hazard ratio[HR] 1.05; p=0.029), SUVmax (HR 2.23; p=0.041), and predominant histologic subtype grouping (LEP versus ACN/PAP HR 5.61; p=0.002, LEP versus MIP/SOL HR 5.59; p=0.009). In analyses of recurrence-free survival, SUVmax (HR 2.27; p=0.028) and sex (HR 2.67; p=0.012) were independent poor prognostic factors. Receiver operating characteristic curve analysis revealed that a optimal cut-off value of SUVmax for survival and recurrence was 4.66.
Conclusion : In patients with pathologic stage Ⅰ adenocarcinoma, SUVmax and predominant histologic subtype are independent prognostic factors, and SUVmax has significant adverse impact on recurrence, too. SUVmax and predominant histologic subtype are thought to be useful in determining the optimal therapeutic policy and in contributing to improving the postoperative prognosis.
책임저자: Pil Jo Choi
Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
발표자: Jung Hoon Yi, E-mail : yjh051@daum.net