P1.05-043 Survival Following Surgical Resection of Lung Adenocarcinoma Stratified According to Morphological Sub-Type

P1.05-043 Survival Following Surgical Resection of Lung Adenocarcinoma Stratified According to Morphological Sub-Type

S640 Journal of Thoracic Oncology P1.05-043 Survival Following Surgical Resection of Lung Adenocarcinoma Stratified According to Morphological Sub-Ty...

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S640

Journal of Thoracic Oncology

P1.05-043 Survival Following Surgical Resection of Lung Adenocarcinoma Stratified According to Morphological Sub-Type Topic: Surgery Haval Balata, Timothy Edwards, Charlene Tennyson, Philip Foden, Anshuman Chaturvedi, Philip Crosbie, Richard Booton, Matthew Evison University Hospitals of South Manchester, Manchester/United Kingdom Background: Lung adenocarcinoma is the commonest histological sub-type of Non-small cell lung cancer (NSCLC) and a leading cause of death worldwide. Identifying factors that may influence survival or the risk of recurrence following resection of lung adenocarcinoma may inform adjuvant strategies and the intensity of surveillance programs. The aim of this study was to assess the effect of morphological sub-type on survival following surgical resection. Methods: Patients who underwent surgical resection for non-small cell lung cancer between 2011 and 2014 at a tertiary thoracic surgical and lung cancer center were identified from pathological records (n¼1387). Patients with adenocarcinoma (n¼705) were selected and the predominant morphological subtyping was recorded. Survival data was obtained from national death registries. Results: Of the 705 adenocarcinomas, Acinar (n¼325), Lepidic (n¼133) and Solid (n¼131) were the most frequent histological subtypes identified. Numbers for other subtypes were small and therefor 3 year survival was not always possible to calculate. Survival by histological subtypes Histology Acinar (N¼325) Glandular (N¼17) Lepidic (N¼133) Micropapillary (N¼3) Mixed (N¼26) Papillary (N¼38) Solid (N¼131) Unknown (N¼31)

No. of Deaths 1 year 2 year 3 year during follow-up survival survival survival 93 5

90.5% 94.1%

79.2% -

68.3% -

32

92.5%

84.4%

76.6%

1

-

-

-

9 11

84.6% 78.9%

71.3% 76.3%

-

50 10

81.7% 93.5%

67.1% 71.5%

59.7% -

Conclusion: A difference in survival can be seen between the three commonest adenocarcinoma subtypes (Acinar, Lepidic and Solid) at 1, 2 and 3 years

Vol. 12 No. 1S

following surgical resection. Interpreting results on other sub-types is limited by small numbers. Lepidic and Solid have the best and worst survival rates respectively. Limitations include a lack of adjustment for pathological stage or co-morbidities and a lack of cancer-specific mortality data. Future studies may evaluate if the morphology of lung adenocarcinomas could have a role in defining adjuvant and surveillance strategies. Keywords: NSCLC, Surgery, Adenocarcinoma, survival

P1.05-044 The Impact of IASLC 8th Edition Updates for T-Classification for Lung Cancer in a US Population-Based Surgical Resection Cohort Topic: Surgery Matthew Smeltzer,1 Nicholas Faris,2 Carrie Fehnel,2 Cheryl Houston-Harris,2 Meredith Ray,1 Yu-Sheng Lee,1 Meghan Meadows,1 Sam Signore,2 Chris Mutrie,2 Edward Robbins,2 Raymond Osarogiagbon2 1Epidemiology and Biostatistics, University of Memphis School of Public Health, Memphis/TN/United States of America, 2 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis/TN/United States of America Background: Accurate staging of non-small cell lung cancer (NSCLC) is vital for prognostication and treatment selection. We evaluated the impact of the 8th Edition TNM (8E) T-classification in a US regional NSCLC resection database. Methods: Curative-intent NSCLC resections from 11 hospitals in 4 contiguous Dartmouth Hospital Referral Regions within 3 US states from 2009-2016 were restaged based on 8E T-categorization. Survival analyses were conducted using the Kaplan-Meier method and proportional hazards models with adjusted hazard ratios (aHR) controlling for age, histology, grade, pN-category, and comorbidities. M1 patients and those who received neoadjuvant therapy were excluded. Results: The 2245 patients had a median age of 65, were 48% female, 78% white, 21% black. The 961 pT1 (8E) distribution was 10% pT1a, 52% pT1b, and 39% pT1c. The 793 pT2 (8E) patients were 82% pT2a and 18% pT2b. Of the 318 patients with pT3 (8E), 134 (42%) were pT2b based on the 7th Edition TNM (7E); of the 152 with pT4 (8E), 107 (70%) were pT3 based