P188. Prognostic role of preoperative increase in consolidation to tumor ratio in lung adenocarcinomas presenting as part solid nodules
Presented During: Thoracic Poster Session II
"Tor Vergata" University of Rome, Rome, Italy
rome, Rome
Italy - Contact Me
I am a resident in thoracic surgery in Rome, Italy. I have spent the last years in the National Cancer Institute in Rome where I have developed a strong interest in clinical and translational research about thoracic malignancy and particularly lung cancer. My main areas of interest range from the molecular characterization perioperative treatment of early stage lung cancer, periperative management of thoracic patients and thymic epithelial disease. I am now attending a research period at the McGill University to improve my research skills in lung cancer.
Sunday, May 4, 2025: 9:00 AM - 4:00 PM
Seattle Convention Center | Summit
Room: Poster Area, Exhibit Hall
Description
Objective. Aim of the study is to evaluate the role of consolidation-to-tumor ratio increase during the preoperative radiological follow up as a prognostic factor in completely resected lung adenocarcinomas presenting as part-solid nodules.
Methods. In this retrospective single-center study, completely resected part-solid adenocarcinoma in the period between May 2016 and December 2023 were evaluated. Only patients undergoing at least two computed tomography (CT) scans in the preoperative period (interscan period 1-12 months) were enrolled. Solid component and overall tumor mean diameter as well as CTR were assessed at diagnosis and within 1-month from surgery. Disease free survival (DFS) was estimated by Kaplan Meier method according to solid component, overall tumor diameter or CTR increase. Cox regression was performed including main clinical, radiological and pathological variables as well as solid component, overall tumor diameter or CTR increase.
Results. 104 patients were enrolled. Median preoperative follow-up was 6 months (IQR 3-12). Overall, CTR increase was observed in 39 (37.5%) patients while overall tumor growth and solid component growth were observed in 44 (42.3%) and 46 (44.2%) patients, respectively. According to Kaplan-Meier estimation (figure 1a), patients with CTR increase had a worse 3-year DFS compared to those with stable or diminished CTR (55.2% versus 87.2%; p=0.009). Similarly, solid component increase (61% versus 87.7%; p=0.03) but no overall tumor dimension increase (71.3% versus 77.9%; p=0.35) were associated with worse DFS. At univariable analysis (Figure 1b), prognostic factors for DFS were smoking history (0.01), upstaging (0.013), CTR increase (0.014) and solid component increase (0.037). To avoid potential multicollinearity, CTR increase, and solid component increase were evaluated separately in multivariable analysis (Figure 1c). Smoking history and upstaging were associated to DFS in both multivariable analyses. When evaluated singularly, CTR increase was independently associated with DFS (p=0.03) while solid component increase failed to predict DFS (p=0.05)
Conclusion. CTR increase during preoperative follow up can be useful to identify those part-solid lung adenocarcinoma at higher risk of recurrence despite complete resection. If confirmed and validated in further studies, these results may help to better stratify patients with part-solid nodules prognosis and to tailor surgical strategy.
Authors
Riccardo Tajè (1), Filippo Tommaso Gallina (2), Mauro Caterino (3), Daniele Forcella (4), Alexandro Patirelis (5), Gabriele Alessandrini (3), Fabiana Letizia Cecere (3), Federico Cappelli (3), Isabella Sperduti (6), Paolo Visca (4), Enrico Melis (3), Antonello Vidiri (3), Federico Cappuzzo (4), Francesco Facciolo (4), Vincenzo Ambrogi (7)
Institutions
(1) Tor Vergata University, rome, Rome, (2) McGill University Health Centre, Rome, QC, (3) IRCCS National Cancer Institute Regina Elena, rome, NA, (4) IRCCS Regina Elena National Cancer Institute, Rome, NA, (5) Tor Vergata University, rome, NA, (6) Biostatistics, Regina Elena National Cancer Institute, IRCCS, Rome, Italy, Rome, Rome, (7) Tor Vergata University, Rome, Italy
Methods. In this retrospective single-center study, completely resected part-solid adenocarcinoma in the period between May 2016 and December 2023 were evaluated. Only patients undergoing at least two computed tomography (CT) scans in the preoperative period (interscan period 1-12 months) were enrolled. Solid component and overall tumor mean diameter as well as CTR were assessed at diagnosis and within 1-month from surgery. Disease free survival (DFS) was estimated by Kaplan Meier method according to solid component, overall tumor diameter or CTR increase. Cox regression was performed including main clinical, radiological and pathological variables as well as solid component, overall tumor diameter or CTR increase.
Results. 104 patients were enrolled. Median preoperative follow-up was 6 months (IQR 3-12). Overall, CTR increase was observed in 39 (37.5%) patients while overall tumor growth and solid component growth were observed in 44 (42.3%) and 46 (44.2%) patients, respectively. According to Kaplan-Meier estimation (figure 1a), patients with CTR increase had a worse 3-year DFS compared to those with stable or diminished CTR (55.2% versus 87.2%; p=0.009). Similarly, solid component increase (61% versus 87.7%; p=0.03) but no overall tumor dimension increase (71.3% versus 77.9%; p=0.35) were associated with worse DFS. At univariable analysis (Figure 1b), prognostic factors for DFS were smoking history (0.01), upstaging (0.013), CTR increase (0.014) and solid component increase (0.037). To avoid potential multicollinearity, CTR increase, and solid component increase were evaluated separately in multivariable analysis (Figure 1c). Smoking history and upstaging were associated to DFS in both multivariable analyses. When evaluated singularly, CTR increase was independently associated with DFS (p=0.03) while solid component increase failed to predict DFS (p=0.05)
Conclusion. CTR increase during preoperative follow up can be useful to identify those part-solid lung adenocarcinoma at higher risk of recurrence despite complete resection. If confirmed and validated in further studies, these results may help to better stratify patients with part-solid nodules prognosis and to tailor surgical strategy.
Authors
Riccardo Tajè (1), Filippo Tommaso Gallina (2), Mauro Caterino (3), Daniele Forcella (4), Alexandro Patirelis (5), Gabriele Alessandrini (3), Fabiana Letizia Cecere (3), Federico Cappelli (3), Isabella Sperduti (6), Paolo Visca (4), Enrico Melis (3), Antonello Vidiri (3), Federico Cappuzzo (4), Francesco Facciolo (4), Vincenzo Ambrogi (7)
Institutions
(1) Tor Vergata University, rome, Rome, (2) McGill University Health Centre, Rome, QC, (3) IRCCS National Cancer Institute Regina Elena, rome, NA, (4) IRCCS Regina Elena National Cancer Institute, Rome, NA, (5) Tor Vergata University, rome, NA, (6) Biostatistics, Regina Elena National Cancer Institute, IRCCS, Rome, Italy, Rome, Rome, (7) Tor Vergata University, Rome, Italy