초록접수 현황
| 20F-079 | 구연 발표 |
Occult N1 Lymph Node Metastases in pT1ab Lung Adenocarcinoma: Predictors and Implications for Sublobar Resection
Woohyun Jung, Chia-Hui Shih, So Young Leea, Jae Hyun Jeona, Yoo Hwa Hwanga, Sukki Cho, Sanghoon Jheon, and Kwhanmien Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
Purpose : Occult N1 lymph node metastasis (ON1M) is a strong candidate factor causing locoregional recurrence after sublobar resection. The aims of this study were to determine robust predictive factors of ON1M, and to elucidate its impact on postoperative recurrence in pT1ab lung adenocarcinoma (ADC).
Methods : A total of 809 patients with clinical N0 and pT1ab ADC who underwent surgical resection from January 2009 to December 2019 were included in this retrospective study. Risk analysis for ON1M, and joint effect analysis for recurrence-free survival (RFS) between sublobar resection and risk factors for ON1M were performed.
Results : In multivariable logistic regression analysis, the lymphatic invasion (LI) and primary tumor maximum standardized uptake value ≥ 1.5 g/ml (high SUVmax) predicted ON1M well (P=.001 and .049, respectively). LI showed the greatest feature importance in Elastic-Net model. In the joint effect analysis, sublobar resection had a significantly higher risk of recurrence than lobar resection, with synergistic effect if risk factors for ON1M were present; if sublobar resection was performed for pT1ab ADC presenting both LI and high SUVmax, 5-year RFS was 44.4% and the relative excess risk due to interaction was 14.184. Regional LNs were the most common site of recurrence when both LI and high SUVmax were present.
Conclusion : In pT1ab ADC, the robust predictive factors of ON1M were LI and high SUVmax (≥1.5 g/ml). Sublobar resection have a significantly higher risk of recurrence than lobar resection if risk factors for ON1M, i.e., both high SUVmax and LI, are present.
Methods : A total of 809 patients with clinical N0 and pT1ab ADC who underwent surgical resection from January 2009 to December 2019 were included in this retrospective study. Risk analysis for ON1M, and joint effect analysis for recurrence-free survival (RFS) between sublobar resection and risk factors for ON1M were performed.
Results : In multivariable logistic regression analysis, the lymphatic invasion (LI) and primary tumor maximum standardized uptake value ≥ 1.5 g/ml (high SUVmax) predicted ON1M well (P=.001 and .049, respectively). LI showed the greatest feature importance in Elastic-Net model. In the joint effect analysis, sublobar resection had a significantly higher risk of recurrence than lobar resection, with synergistic effect if risk factors for ON1M were present; if sublobar resection was performed for pT1ab ADC presenting both LI and high SUVmax, 5-year RFS was 44.4% and the relative excess risk due to interaction was 14.184. Regional LNs were the most common site of recurrence when both LI and high SUVmax were present.
Conclusion : In pT1ab ADC, the robust predictive factors of ON1M were LI and high SUVmax (≥1.5 g/ml). Sublobar resection have a significantly higher risk of recurrence than lobar resection if risk factors for ON1M, i.e., both high SUVmax and LI, are present.
첨부파일 : 2. ON1M_Abstract.pptx
책임저자: Kwhanmien Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea
발표자: Woohyun Jung, E-mail : chucky0406@gmail.com