61PD - Recurrence risk-scoring model for resected stage I lung adenocarcinoma with solid component

Date 06 May 2017
Event ELCC 2017
Session Imaging and locally advanced NSCLC
Topics Lung and other Thoracic Tumours
Presenter JIE Qian
Citation Annals of Oncology (2017) 28 (suppl_2): ii20-ii23. 10.1093/annonc/mdx085
Authors J. Qian1, J. Xu1, S. Wang1, W. Yang1, F. Qian1, B. Zhang1, R. Wang2, X. Zhang1, H. Wang1, B. Han1
  • 1Department Of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, 200030 - Shanghai/CN
  • 2Department Of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, 200030 - Shanghai/CN

Abstract

Background

The presence of solid histologic pattern in lung adenocarcinoma (ADC) is associated with early recurrence. However, individualized prognosis in patients with solid component is still unclear. This study aimed to develop a nomogram predicting the recurrence probability in stage I lung ADC patients with solid component.

Methods

A total of 5904 patients with stage I lung ADC who underwent curative surgical resection from January 2008 through December 2014 at Shanghai Chest Hospital were retrospectively reviewed. Tumors were subtyped by using the IASCL/ATS/ERS classification. Of these patients, 708 contained a solid component. Prognostic value of gender, age at diagnosis, smoking history, operation type, tumor location, tumor size, pathological subtype, cell differentiation, lymphovascular and visceral pleural invasion were investigated. Multivariate Cox regression analysis of recurrence-free survival (RFS) in patients with solid component was performed and a nomogram to predict RFS was constructed. The nomogram was internally validated.

Results

The overall recurrence rate in patients with solid component was 25.0% (177/708), with predominant solid subtype and minor solid component in 49.2% (87/177) and 50.8% (90/177) of cases, respectively. Larger tumor size (P = 0.002), predominant solid component (P = 0.003), advanced age at diagnosis (P = 0.015), and visceral pleural invasion (P = 0.040) were associated with an increased risk of recurrence and were included in the nomogram. The predictive model had a concordance index of 0.643 (95% confidence interval, 0.601-0.685) and showed good calibration.

Conclusions

The nomogram model including identified risk factors for RFS is applicable in treatment decision-making for early stage lung ADC with pathological solid component. External validation is required to recommend this nomogram in routine practice.

Clinical trial identification

Legal entity responsible for the study

Shanghai Chest Hospital

Funding

Shanghai Chest Hospital

Disclosure

All authors have declared no conflicts of interest.