초록접수 현황
| 16F-252 | 구연 발표 |
Prognostic Value of Lung Adenocarcinoma Subtype in Resected Stage I Invasive Adenocarcinoma
Seokkee Lee¹, Chang Young Lee¹, Hyo Sup Shim², Jee Won Shu¹, Kyung Sik Nam¹, Jin Gu Lee¹, Dae Joon Kim¹, Hyo Chae Paik¹, Kyung Young Chung¹
¹Department of Thoracic and Cardiovascular Surgery, ²Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : Several studies have been reported that patients with solid (S) or micropapillary (MP) predominant patterns showed a worse prognosis. However, the prognosis of patients who have S or MP patterns (over 5%), even if their patterns are not predominant, remains uncertain and is still investigating. In this study, we evaluated the clinical impact of the presence of S or MP subtype on the oncologic outcomes in surgically resected stage I adenocarcinoma.
Methods : Between January 2006 to December 2013, 707 consecutive patients were treated surgically for pathologic stage I adenocarcinoma. Patients were excluded from this study if they underwent neoadjuvant therapy or they had adenocarcinoma in situ or minimally invasive adenocarcinoma, or pathologic slides are not available to reevaluate. Finally a total 673 patients were enrolled. The slides were evaluated according to the 2015 WHO classification; each histologic pattern present was recorded in 5% increments.
Results : Baseline characteristics were summarized in Table 1. Acinar predominant was most common type (n=324, 48.1%). S or MP predominant type was observed in 10.7% and 2.5%. S or MP component equal to or over 5% was found in 20.2% and 36.1%, respectively. In univariate analysis, the presence of S or MP component had lower disease free survival with statistical significance (p=0.004, p<0.001 respectively. Fig.1.). In multivariate analysis, S or MP component was revealed as an independent risk factor for disease free survival (HR = 3.03, CI=1.69-5.46, p<0.001) and overall survival (HR=3.43, CI= 1.92-6.11, p<0.001).
Conclusion : This study demonstrated that patients with S or MP components have worse prognosis even if their components are not predominant. These results might help clinicians to select the candidates for adjuvant treatments although they have stage I adenocarcinoma.
Methods : Between January 2006 to December 2013, 707 consecutive patients were treated surgically for pathologic stage I adenocarcinoma. Patients were excluded from this study if they underwent neoadjuvant therapy or they had adenocarcinoma in situ or minimally invasive adenocarcinoma, or pathologic slides are not available to reevaluate. Finally a total 673 patients were enrolled. The slides were evaluated according to the 2015 WHO classification; each histologic pattern present was recorded in 5% increments.
Results : Baseline characteristics were summarized in Table 1. Acinar predominant was most common type (n=324, 48.1%). S or MP predominant type was observed in 10.7% and 2.5%. S or MP component equal to or over 5% was found in 20.2% and 36.1%, respectively. In univariate analysis, the presence of S or MP component had lower disease free survival with statistical significance (p=0.004, p<0.001 respectively. Fig.1.). In multivariate analysis, S or MP component was revealed as an independent risk factor for disease free survival (HR = 3.03, CI=1.69-5.46, p<0.001) and overall survival (HR=3.43, CI= 1.92-6.11, p<0.001).
Conclusion : This study demonstrated that patients with S or MP components have worse prognosis even if their components are not predominant. These results might help clinicians to select the candidates for adjuvant treatments although they have stage I adenocarcinoma.
책임저자: Kyung Young Chung
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Seokkee Lee, E-mail : cslsk8@yuhs.ac