STS 2019: Identifying Candidates for Adjuvant Therapy for Early-Stage Lung Adenocarcinoma
Posted: Friday, March 29, 2019
For patients with pathologic stage I lung adenocarcinoma, those with pathologic invasive tumor size of more than 2 cm, pleural invasion, or vascular invasion may be at high risk for recurrence, according to findings presented at the 2019 Society of Thoracic Surgeons (STS) Annual Meeting in San Diego. This cohort may represent potential candidates for adjuvant therapy, concluded Yasuhiro Tsutani, MD, PhD, of Hiroshima University, Japan, and colleagues.
Researchers focused on data from 536 patients enrolled in a prospective multi-institutional study (JCOG0201) who were diagnosed with pathologic stage I lung adenocarcinoma and underwent lobectomy. Pathologic invasive tumor size was used as tumor size on the basis of the 8th edition of the TNM classification.
In all patients, the 10-year relapse-free survival rate was 83.9%, with median follow-up periods of 10.2 years. Multivariable Cox analysis found four independent prognostic factors for relapse-free survival: age (> 65 years, hazard ratio = 2.60), pathologic invasive tumor size (> 2 cm, hazard ratio = 2.70), pleural invasion (hazard ratio = 2.17), and vascular invasion (hazard ratio = 2.59).
Dr. Tsutani’s team discovered a significant difference in relapse-free survival when patients were divided into high-risk (pathologic invasive tumor size of > 2 cm or positive for pleural invasion or vascular invasion) and low-risk (pathologic invasive tumor size of 2 cm and negative for pleural invasion and vascular invasion) cohorts. The high-risk group (124 patients) demonstrated a hazard ratio of 3.61.
Disclosure: The study authors’ disclosure information can be found at sts.org.
