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disease after surgery were treated by EGFR-TKI and 17 patients were treated by other
cytotoxic agents. In the patients treated by EGFR-TKI, the MST in patients with
EGFR mutation (n = 15) was 53.4 months, which was significantly superior than that
in patients without EGFR mutation (n = 9) of 20.1 months. In patients treated by
cytotoxic agents, there was no difference in OS between EGFR-mutation positive and
negative groups. Six of 7 patients with EML4-ALK fusion gene are alive without
recurrent disease. However, the evaluation of prognostic value of EML4-ALK and
B-RAF was difficult because of the small number of patient with mutation.
Conclusion: In patients with stage I adenocarcinoma, the mutation of K-ras gene
was a poor prognostic factor for recurrence, and the mutation of EGFR was a
predictive factor for EGFR-TKI treatment after recurrence.
Disclosure: All authors have declared no conflicts of interest.
1188P EXAMINATION OF PATHOLOGICAL STAGE IB NON-SMALL
CELL LUNG CANCER—ADEQUACY OF PLEURAL
INFILTRATION ASSESSMENT
R. Nakahara 1 , H. Suzuki 1 , S. Igarashi 2 , H. Matsuguma 1
1 Division of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, JAPAN,
2 Division of Pathology, Tochigi Cancer Center, Utsunomiya, JAPAN
Background: In January 2010, the TNM classification of lung cancer was revised
(7th version). The T factor was more closely divided, and lung cancer with 3 cm or
less in greatest dimension and infiltration of visceral pleura was classified as the T2a
group.
Purpose: We examined whether the evaluation of visceral pleural infiltration in the
new TNM classification is appropriate.
Methods: Among patients with non-small cell lung cancer who underwent radical
surgery in our hospital between October 1986 and December 2006, pathological T1
to T3N0M0 tumors were detected in 625. Of these, we performed survival analysis in
197 with T2aN0M0 (stage IB) tumors using gender, age, pleural infiltration (p),
lymph vessel invasion (ly), and vascular infiltration (v) as prognostic factors.
Furthermore, the stage-IB patients were divided into 3 groups based on the tumor
diameter (s) and visceral pleural infiltration (p): Group A: s ≤ 3 cm, p1,2 (n = 49),
Group B: 3 cm < s ≤ 5 cm, p0 (n = 101), and Group C: 3 cm < s ≤ 5 cm, p1,2 (n = 47).
We compared the survival rate among the 3 groups, and investigated differences from
the survival rates in the IA to IIB groups.
Results: Concerning the clinical background of the 197 stage-IB patients, the mean
age was 68 years (37 to 87), and the number of males was 128 (65%). The number of
patients with adenocarcinoma was 125 (63%), and that of patients with squamous
cell carcinoma was 61 (31%). Univariate analysis showed that advanced age, male
gender, p(+), and v(+) were significant prognostic factors. On multivariate analysis,
age (p = 0.0002) and p factor (p = 0.0007) alone were regarded as independent
prognostic factors. The 5-year survival rates in Groups A, B, and C were 61, 82, and
57%, respectively. There were significant differences between Groups A and B
(p = 0.0074), as well as between Groups B and C (p = 0.0058). In the p(+) factor
group, the prognosis was significantly less favorable than in the p(-) factor group.
The survival rates in Groups A and C were similar to the 5-year survival rate in
T2bN0M0 (stage IIA) patients (64%).
Discussion: In this study, p(+) patients showed an unfavorable prognosis regardless
of the tumor diameter. When selecting the T factor, it should be evaluated as higher
in p(+) patients.
Disclosure: All authors have declared no conflicts of interest.
1189P IMPACT OF ADENOCARCINOMA VERSUS
SQUAMOUS-CELL-CARCINOMA HISTOLOGY ON SURVIVAL
OF RESECTED STAGE I-II NON-SMALL CELL LUNG CANCER
(NSCLC) IN A COHORT OF 509 PATIENTS
J. Bosch-Barrera 1 , X. Baldo 2 , M. Rubio 2 , M. Buxó 3 , L. Vilardell 3 , R. Porta 1 ,
E. Marmol 2 , N. Basté 1 , A. Izquierdo 1 , F. Sebastian 2
1 Oncology, Catalan Institute of Oncology, Girona, SPAIN, 2 Thoracic Surgery,
Hospital Universitari de Girona Dr. Josep Trueta, Girona, SPAIN, 3 Epidemiology
Unit and Cancer Registry of Girona, Oncology Planning, Department of Health,
Girona Biomedical Research Institute, Girona, SPAIN
Annals of Oncology
Background: Histology is a prognostic and predictor of the response factor in
advanced non-small cell lung cancer (NSCLC). Adenocarcinoma (ADC) has a better
prognosis in advanced NSCLC whereas it is considered that resected patients (pts)
with squamous-cell-carcinoma (SqCC) have a better outcome. We have analyzed our
experience of resected stage I-II NSCLC pts to determine the impact of ADC vs
SqCC histology in this setting.
Methods: From 1996 to 2010, 289 stage I pts and 220 stage II pts were treated by
surgery. Chemotherapy (CT) was administered in 19 (6.6%) pts with stage I disease
and 94 (42.7%) pts with stage II disease. Overall survival (OS) and cause-specific
survival (CSS) curves were estimated by Kaplan-Meier analysis and differences were
assessed with the log-rank test or the Peto and Peto modification of the
Gehan-Wilcoxon test.
Results: Most pts (92.9%) were men. Median age was 68 years and mean follow-up
was 37.4 months. Median OS for pts with stage I NSCLC was 68 mo (IC 95: 55-123)
for ADC and 55 mo (IC 95: 47-67) for SqCC (p = 0.0604) with an estimated OS at 5
years of 54.1% vs 48%. Median CSS were not achieved in the two histology groups,
with an estimated CSS at 5 years of 78.3% for ADC versus 71.5% for SqCC (p = 0.
626). For pts in stage II disease, the median OS was 31 mo (IC 95: 21-45) for ADC
and 24 mo (IC 95: 18-34) for SqCC (p = 0.515) with an estimated OS at 5 years of
20.5% vs 29.6%. Median CSS were 45 mo (IC 95: 31-NA) for ADC and 93 mo (IC
95: 39-NA) for SqCC (p = 0.462), with an estimated CSS at 5 years of 44.8% vs
54.3%.
Conclusions: A trend for better OS of ADC was observed in stage I compared to
SqCC but it disappeared for CSS. Thus, no statistically significant differences in OS
nor CSS were observed in resected stage I-II NSCLC patients between ADC vs SqCC
histology.
Disclosure: All authors have declared no conflicts of interest.
1190P SPECIFICITIES OF LUNG CANCER IN NEVER-SMOKING
WOMEN
J. Mazieres 1 , I. Rouquette 1 , B. Lepage 1 , J. Milia 1 , P. Validire 2 , P. Hofman 3 ,
M. Beau-Faller 4 , L. Brouchet 1 , P. Fouret 5
1 Thoracic Oncology, CHU Toulouse - Hôpital Larrey, toulouse, FRANCE,
2 Pathology, Institut Mutualiste Montsouris, Paris, FRANCE, 3 Pathology, CHU
Nice, Nice, FRANCE, 4 Pathology, CHU Strasbourg, Strasbourg, FRANCE,
5 Pathologie, APHP-La Salpetrière, PAris, FRANCE
Introduction: Based on epidemiological, clinical, and preclinical data, lung
carcinogenesis can be distinctive in women. No clear data is available to help us
understand the high rate of tobacco-independent lung cancer in women. We
hypothesize that genetic events or hormonal factors might be partly involved in these
tobacco-independent lung cancers.
Method: We thus aimed to compare clinical, pathological and biological
characteristics of lung cancer in two cohorts of smoking and never smoking women.
A population of 140 women (63 never-smokers and 77 former or current smokers)
carrying adenocarcinoma issued from our centre and a national collection has been
included in this study.
Results: The non-smoking population was characterized by a higher age (67yrs
vs 58.7, p < 0.0001) and a higher frequency of a lepidic component (60.3% vs
37.7 %, p = 0.008) than the smoking patients. We observed a differential genetic
alteration repartition in women according to their tobacco status: 50.8% of
never-smokers displayed EGFR mutation vs. 10.4% of smokers (p < 0.001). At
the opposite KRas mutation was more frequently mutated in smokers (33.8%)
than in never-smokers (9.5%, p = 0.001). We also observed a higher percentage
of ERα (p = 0.03 by using the breast cancer score) and ERβ expression (p = 0.02)
for non-smoking patients compared with smoking ones. We found no significant
differences for progesterone receptors. Lastly ER expression was correlated with
EGFR mutation.
Conclusion: This study suggests that lung cancer occurring in never-smoking
women is more frequently associated with EGFR mutation and ER expression,
with a correlation between both markers. These findings underline the possibility
of therapy in non-smoking-women targeting both hormonal factors and genetic
abnormalities.
Disclosure: All authors have declared no conflicts of interest.
ix388 | Abstracts Volume 23 | Supplement 9 | September 2012