1188P - What are radiographic findings for predicting indolent lung adenocarcinoma?

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Non-Small Cell Lung Cancer
Staging Procedures (clinical staging)
Basic Principles in the Management and Treatment (of cancer)
Imaging
Presenter Takahiro Mimae
Citation Annals of Oncology (2014) 25 (suppl_4): iv409-iv416. 10.1093/annonc/mdu347
Authors T. Mimae1, Y. Miyata1, Y. Tsutani1, T. Yoshiya1, N. Tsubokawa1, H. Nakayama2, S. Okumura3, M. Yoshimura4, M. Okada1
  • 1Surgical Oncology Dept., Hiroshima University, 7348551 - Hiroshima/JP
  • 2Thoracic Oncology, Kanagawa Cancer Center Hospital, Yokohama/JP
  • 3Department Of Thoracic Surgery, Cancer Institute Hospital, Tokyo/JP
  • 4Thoracic Surgery, Hyogo Cancer Center, 673-8558 - Akashi/JP

Abstract

Aim

Small pulmonary nodules are often followed up. The aim of this study was to establish radiographic criteria with which to accurately and reproducibly predict indolent cancers including adenocarcinoma in situ.

Methods

The correlations between preoperative factors and surgical outcomes, including pathological findings and prognosis among 747 patients with clinical stage IA lung adenocarcinoma that had been completely resected at multiple institutions were examined. Indolent cancers were defined as follows: tumors without lymphatic, blood vessel, pleural invasion or lymph node involvement (LY0V0PL0N0) regardless of stromal invasion.

Results

Pathological assessments of specimens of 44 of 99 (44%) pure ground glass opacity (GGO) tumors including 3 (20%) of 15 pure GGO tumors ≤ 1 cm, revealed partially invasive components. Receiver operating characteristic curves for LY0V0PL0N0 revealed solid tumor size ≤ 6 mm on high-resolution computed tomography (HRCT) or maximum standardized uptake values (SUVmax) ≤ 0.6 on 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT) as radiographic indolent tumor criteria to predict indolent tumors. Among 253 (34%) of 747 patients who met these criteria, none developed recurrence over a median follow-up of 38.6 months.

Conclusions

The lesions showing pure GGO on HRCT could pathologically include invasive components and would not correspond to adenocarcinoma in situ. SUVmax on PET/CT and solid tumor size on HRCT can predict indolent LY0V0PL0N0 lung tumors that can be followed up.

Disclosure

All authors have declared no conflicts of interest.