Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
Keywords: Extracapsular invasion, Metastatic lymph node, lung
adenocarcinoma, Micropapillary subtype
Keywords: micropapillary and solid, Histological subtypes, lymph node
metastases, lung adenocarcinomas
MA12: MISCELLANEOUS BIOLOGY/PATHOLOGY
TUESDAY, DECEMBER 6, 2016 - 14:15-15:45
MA12: MISCELLANEOUS BIOLOGY/PATHOLOGY
TUESDAY, DECEMBER 6, 2016 - 14:15-15:45
MA12.09 COMPARATIVE HISTOLOGICAL SUBTYPE ANALYSIS OF
LUNG ADENOCARCINOMA TUMOR AND METASTATIC LYMPH
NODES AND THE PROGNOSTIC IMPACT
Shaohua Lu 1 , Takashi Eguchi 2 , Zachary Tano 2 , Daniela Molena 2 , David Jones 2 ,
William Travis 1 , Prasad Adusumilli 2
1 Department of Pathology, Memorial Sloan Kettering Cancer Center, New York/
NY/United States of America, 2 Thoracic Service, Department of Surgery, Memorial
Sloan Kettering Cancer Center, New York/NY/United States of America
Background: The goal of this study is to investigate comprehensive
comparative pathological analyses of both primary tumor and metastatic
lymph node (LN) and correlate with lung cancer-specific death (LC-death)
in patients with LN-positive lung adenocarcinoma. Methods: PN1/2 lung
adenocarcinoma patients who underwent R0 resection without induction
therapy (n=402, 2000-2012) were included in the study. In primary tumor,
lymphatic/vascular/pleural invasion, necrosis, tumor spread through
air spaces (STAS), as well as histologic subtypes according to 2015 WHO
classification were evaluated. In metastatic LN, metastatic tumor size,
extracapsular invasion, histologic subtypes were evaluated. Recurrence
and LC-death were analyzed by Cox model. Results: Micropapillary and
solid predominant subtypes were more frequent in LN metastases than in
primary tumors (Figure). In multivariable analyses, adjuvant chemotherapy,
pleural invasion, extracapsular invasion of LN metastasis, micropapillary
predominant subtype in LN metastasis were independent factors for
recurrence; adjuvant chemotherapy, pleural invasion, tumor STAS, and
extracapsular invasion were for LC-death (Table). Conclusion: In lung
adenocarcinoma lymph node metastases, predominant micropapillary
pattern and extracapsular invasion indicate high risk for recurrence and lung
cancer-specific death.
MA12.10 HISTOLOGICAL SUBTYPING OF MATCHED PRIMARY AND
METASTASES SITES IN LUNG ADENOCARCINOMA: SIGNIFICANCE
OF SOLID PREDOMINANCE
Yusuke Takahashi 1 , Takashi Eguchi 1 , Shaohua Lu 2 , Robert Downey 1 , David
Jones 1 , William Travis 2 , Prasad Adusumilli 1
1 Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center,
New York/NY/United States of America, 2 Department of Pathology, Memorial Sloan
Kettering Cancer, New York/NY/United States of America
Background: Clinical significance of 2015 WHO classification histological
subtype of early-stage lung adenocarcinoma (LADC) has been well
documented; the incidence and significance of histological subtypes in
autologous metastatic tumors is unknown. Methods: Histological subtyping
was performed on paired primary and metastatic LADC tumor samples from
patients who underwent resection of metastases (N=203, 1996-2012). 57
cases with inadequate tumor specimen and 4 cases diagnosed as local
recurrence were excluded. Results: Location of metastatic sites were – brain
51 (35.9%), lung 48 (33.8%), lymph node 14 (9.9%), pleura 10 (7.0%), and
adrenal gland 5 (3.5%). Metastatic tumors demonstrated more frequent solid
histological pattern than primary tumors (first predominance: 51% vs. 24%;
second predominance 29% vs. 17%, Figure 1). Among all histological subtypes,
solid subtype showed the highest concordance between primary and
metastatic tumors (Figure 2). In addition, analysis of all available
clinicopathological factors showed significantly higher percentage of solid
subtype in both primary and metastatic tumors was observed in patients with
smoking history (p=0.003 and p=0.004, respectively). Conclusion: Analysis of
a large cohort of primary and autologous metastatic LADC tumors
demonstrated a higher percentage of solid histological pattern metastases,
even in cancers with a low solid component in the primary site of disease.
Copyright © 2016 by the International Association for the Study of Lung Cancer
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