1188P - Examination of pathological stage IB non-small cell lung cancer-adequacy of pleural infiltration assessment

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Non-Small-Cell Lung Cancer, Early Stage
Pathology/Molecular Biology
Presenter Rie Nakahara
Authors R. Nakahara1, H. Suzuki2, S. Igarashi3, H. Matsuguma4
  • 1Thoracic Surgery, Tochigi Cancer Center, 320-0834 - Utsunomiya/JP
  • 2Division Of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya/JP
  • 3Division Of Pathology, Tochigi Cancer Center, Utsunomiya/JP
  • 4Division Of Thoracic Surgery, Tochigi Cancer Center, 320-0834 - Utsunomiya/JP

Abstract

Background

In January 2010, the TNM classification of lung cancer was revised (7th version). The T factor was more closely divided, and lung cancer with 3 cm or less in greatest dimension and infiltration of visceral pleura was classified as the T2a group.

Purpose

We examined whether the evaluation of visceral pleural infiltration in the new TNM classification is appropriate.

Methods

Among patients with non-small cell lung cancer who underwent radical surgery in our hospital between October 1986 and December 2006, pathological T1 to T3N0M0 tumors were detected in 625. Of these, we performed survival analysis in 197 with T2aN0M0 (stage IB) tumors using gender, age, pleural infiltration (p), lymph vessel invasion (ly), and vascular infiltration (v) as prognostic factors. Furthermore, the stage-IB patients were divided into 3 groups based on the tumor diameter (s) and visceral pleural infiltration (p): Group A: s ≤ 3 cm, p1,2 (n = 49), Group B: 3 cm < s ≤ 5 cm, p0 (n = 101), and Group C: 3 cm < s ≤ 5 cm, p1,2 (n = 47). We compared the survival rate among the 3 groups, and investigated differences from the survival rates in the IA to IIB groups.

Results

Concerning the clinical background of the 197 stage-IB patients, the mean age was 68 years (37 to 87), and the number of males was 128 (65%). The number of patients with adenocarcinoma was 125 (63%), and that of patients with squamous cell carcinoma was 61 (31%). Univariate analysis showed that advanced age, male gender, p(+), and v(+) were significant prognostic factors. On multivariate analysis, age (p = 0.0002) and p factor (p = 0.0007) alone were regarded as independent prognostic factors. The 5-year survival rates in Groups A, B, and C were 61, 82, and 57%, respectively. There were significant differences between Groups A and B (p = 0.0074), as well as between Groups B and C (p = 0.0058). In the p(+) factor group, the prognosis was significantly less favorable than in the p(-) factor group. The survival rates in Groups A and C were similar to the 5-year survival rate in T2bN0M0 (stage IIA) patients (64%).

Discussion

In this study, p(+) patients showed an unfavorable prognosis regardless of the tumor diameter. When selecting the T factor, it should be evaluated as higher in p(+) patients.

Disclosure

All authors have declared no conflicts of interest.