1184P - Prognostic factors in early stage non-small cell lung cancer (NSCLC): the importance of number of resected lymph nodes and vascular invasion

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Non-Small-Cell Lung Cancer, Early Stage
Pathology/Molecular Biology
Presenter Miriam Caramanti
Authors M. Caramanti1, R. Berardi1, A. Santinelli2, A. Brunelli3, A. Savini1, P. Mazzanti1, C. Pompili3, M. Salati3, C. Pierantoni1, S. Cascinu4
  • 1Clinica Di Oncologia Medica, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT
  • 2Anatomia Patologica, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, Ancona/IT
  • 3Thoracic Surgery, AOU Ospedali Riuniti Ancona, Ancona/IT
  • 4Dipartimento Di Medicina Clinica E Biotecnologie A, University of Ancona, 60020 - Ancona/IT

Abstract

Introduction

Despite an appropriate surgical treatment, half of early-stage NSCLC patients will die due to lung cancer. The number of resected lymph-nodes and vascular invasion have proved to be a prognostic factor in other solid tumors, as well as breast and colorectal cancer. Here we evaluate their prognostic impact in the largest mono-centric series of resected NSCLC patients.

Methods

Clinical and pathological characteristics and prognostic outcomes of 439 consecutive patients undergoing radical surgical resection for NSCLC at our Institution were evaluated.

Results

The multivariate analysis showed that number of resected lymph nodes, vascular invasion and sex had a prognostic impact on overall survival. The optimal cut-off number of lymph nodes with the highest sensitivity and specificity for estimating the outcome was set at 10 after Receiver Operating Characteristics (ROC) curve analysis. Removing 10 lymph nodes in our study represents a cut-off with a significant prognostic impact particularly in resected stage II NSCLC.

Conclusions

Similarly to other cancer types (i.e. colorectal cancer), our results suggest that an adequate classification of NSCLC should always include an adequate lymph nodes clearance, particularly in stage II NSCLC. Again vascular invasion resulted an independent prognostic factors for overall survival (H.R. 0.82, CI 0.68-0.96, p = 0.042). Therefore the number of resected lymph nodes, together with vascular invasion, may also drive the selection of NSCLC patients for adjuvant treatment.

Disclosure

All authors have declared no conflicts of interest.