89P - Clinical factors of nodal upstaging in pathologic N1 or N2 non-small cell lung cancer

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Non-Small-Cell Lung Cancer, Locally Advanced
Imaging, Diagnosis and Staging
Presenter Youngkyu Moon
Citation Annals of Oncology (2015) 26 (suppl_1): 24-28. 10.1093/annonc/mdv049
Authors Y. Moon, S.W. Sung, K.S. Kim, J.K. Park
  • Thoracic And Cardiovascular Surgery, Seoul St. Mary's Hospital, of the Catholic University, 137-701 - Seoul/KR

Abstract

Aim/Background

Clinical LN stage and pathologic LN stage are very important factors for the treatment of lung cancer especially for the determination of the therapy whether neoadjuvant therapy or adjuvant therapy. However, lymph nodal upstaging or down staging occurred frequently after surgery. The purpose of this study was to evaluate clinical factors of nodal upstaging patients whose lymph node involvement was evaluated by mainly using PET CT and Chest CT.

Methods

Between 2011 and 2014, 634 patients underwent surgical treatment for non-small cell lung cancer at our institution. Except 37 patients who received induction chemotherapy, there were 103 patients who were diagnosed pathologic N1 or N2 non small cell lung cancer. Nodal upstaging patients were classified into Group A and no upstaging patients into Group B. We compared clinical characteristics and pathologic results of group A with group B.

Results

59 patients (57.3%) were in group A and 44 patients (42.7%) were in group B. Group A was characterized by younger age (61.4 vs 68.4, p < 0.001), female (47.5% vs 15.9%, p = 0.001), and lower smoking history (12.2 vs 28.8 pack years, p < 0.001). Most tumors of Group A were adenocarcinoma (n = 39 (66.1%)). Micropapillary component (n = 36, p < 0.001) and EGFR mutation (n = 36, p = 0.001) were more frequent in Group A. Multivariate analysis (Logistic regression) showed that younger age (p = 0.044) and micropapillary component (p = 0.035) were significant correlation factors with nodal upstaging.

Multivariate analysis

OR(Odd ratio) 95% confidence interval p value
Age 0.912 0.834-0.997 0.044
Gender(Female) 3.768 0.435-32.643 0.229
Smoking (pack years) 1.014 0.959-1.071 0.628
Histology(adenocarcinoma) 0.620 0.057-6.722 0.694
EGFR mutation 0.780 0.094-6.482 0.818
Micropapillary component (>5%) 8.062 1.156-56.201 0.035

Conclusions

Younger age and micropaillary component are significantly correlated with nodal upstaging. In those cases, preoperative invasive lymph node staging and intraoperative adequate lymph node dissection are considered to be needed.

Disclosure

All authors have declared no conflicts of interest.