P187. Prognostic Impact of Resection Margin Distance in Patients with Completely Resected Stage I NSCLC after Lobectomy
Presented During: Thoracic Poster Session II
Asan Medical Center
Seoul
South Korea - Contact Me
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine
Sunday, May 4, 2025: 9:00 AM - 4:00 PM
Seattle Convention Center | Summit
Room: Poster Area, Exhibit Hall
Description
Objective: Unlike sublobar resection, the prognostic impact of margin distance has not been fully evaluated in patients who underwent lobectomy for stage I non-small cell lung cancer (NSCLC). We investigated the prognostic value of the resection margin distance and determine the cutoff value in these patients.
Methods: Between 2011 and 2021, data of patients with completely resected stage I NSCLC after lobectomy were analyzed. The margin distance and ratio were defined as the distance from the primary tumor to the bronchial resection margin and the margin distance divided tumor size. The optimal cutoff value was selected using a maximally selected log-rank statistic.
Results: A total of 3,727 patients were included as the final cohort, of whom 211 (5.7%), 1202 (32.3%), 1175 (31.5%), and 1139 (30.6%) patients were in stages IA1, IA2, IA3, and IB, respectively. The most optimal cutoffs for the margin distance and the margin ratio for cancer recurrence within 5 years were 25mm and 1.5, respectively. In the multivariable analysis, the margin distance (<25mm vs. ≥25mm; hazard ratio [HR], 1.34; 95% confidence interval [CI], 1.11–1.61; p = 0.002) and the margin ratio (<1.5 vs. ≥1.5; HR, 1.40; 95% CI, 1.14 to 1.71; p <0.001) were significant factors for recurrence-free survival in patients after lobectomy for stage I NSCLC.
Conclusion: The margin distance has a significant prognostic impact in patients who underwent lobectomy for stage I NSCLC. Cutoff values of margin distance ≥25mm and margin ratio ≥1.5 could help clinicians enact proper treatment strategies and surveillance for these patients.
Authors
Shia Kim (1), Geun Dong Lee (2), Sehoon Choi (3), Hyeong Ryul Kim (4), Yong-Hee Kim (4), Dong Kwan Kim (4), Seung-Il Park (4), Jae Kwang Yun (5)
Institutions
(1) Asan Medical Center, Seoul, South Korea, (2) Asan Medical Center, Seoul, Songpa-gu, (3) Asan Medical Center, Seoul, Seoul, (4) Asan Medical Center, Songpa-gu, Seoul, (5) Asan Medical Center, Seoul, NA
Methods: Between 2011 and 2021, data of patients with completely resected stage I NSCLC after lobectomy were analyzed. The margin distance and ratio were defined as the distance from the primary tumor to the bronchial resection margin and the margin distance divided tumor size. The optimal cutoff value was selected using a maximally selected log-rank statistic.
Results: A total of 3,727 patients were included as the final cohort, of whom 211 (5.7%), 1202 (32.3%), 1175 (31.5%), and 1139 (30.6%) patients were in stages IA1, IA2, IA3, and IB, respectively. The most optimal cutoffs for the margin distance and the margin ratio for cancer recurrence within 5 years were 25mm and 1.5, respectively. In the multivariable analysis, the margin distance (<25mm vs. ≥25mm; hazard ratio [HR], 1.34; 95% confidence interval [CI], 1.11–1.61; p = 0.002) and the margin ratio (<1.5 vs. ≥1.5; HR, 1.40; 95% CI, 1.14 to 1.71; p <0.001) were significant factors for recurrence-free survival in patients after lobectomy for stage I NSCLC.
Conclusion: The margin distance has a significant prognostic impact in patients who underwent lobectomy for stage I NSCLC. Cutoff values of margin distance ≥25mm and margin ratio ≥1.5 could help clinicians enact proper treatment strategies and surveillance for these patients.
Authors
Shia Kim (1), Geun Dong Lee (2), Sehoon Choi (3), Hyeong Ryul Kim (4), Yong-Hee Kim (4), Dong Kwan Kim (4), Seung-Il Park (4), Jae Kwang Yun (5)
Institutions
(1) Asan Medical Center, Seoul, South Korea, (2) Asan Medical Center, Seoul, Songpa-gu, (3) Asan Medical Center, Seoul, Seoul, (4) Asan Medical Center, Songpa-gu, Seoul, (5) Asan Medical Center, Seoul, NA