P2.17-37 Prognostic Implication of Surgical Treatment for the Dominant Lung Adenocarcinoma Associated with Part-Solid Nodules

Abstract

The aim was to analyze the prognostic implication of surgical resection for lung adenocarcinoma appearing as part-solid nodules (PSNs) on computed tomography scans. From 2004 to 2017, the cases of a total of 651 patients (male:female = 259:392, median age, 65years) with surgically resected lung adenocarcinomas manifesting as PSNs were retrospectively reviewed. We compared patient characteristics with t tests for continuous variables and χ2 tests for categorical variables. The prognostic implication of the multiplicity of the surgical extent and other clinical variables in relation to overall-survival (OS) and disease-free survival (DFS) was analyzed by using Cox regression. Median maximum diameter and solid component diameter of PSNs were 2.0cm and 1.1cm. (range 0.8-7, 0.5-3.4) PSNs were resected by wedge resection, segmentectomy, or lobectomy in 94 (14.4%), 92 (14.2%), and 465 (71.4%) cases, respectively. Pathologic diagnosis was adenocarcinoma in situ, minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma (IA) in 4 (0.6%), 70 (10.8%), and 577 (88.6%) cases, respectively. The median follow-up duration was 35.4 months. There was no significant difference of OS and DFS among the surgical extent and type of lymph node dissection (Figure 1). Multivariate Cox regression analysis demonstrated that multiple pulmonary nodules [hazard ratio (HR) = 8.3; 95% confidence interval (CI): 3.5-19.8 1.173; p <0.001] and wedge resection (HR = 3.8; 95% CI: 1.19-11.9; p = 0.02) were independent risk factors for the tumor recurrence. Among the resected lung adenocarcinoma associated with PSNs, multiple PSN and wedge resection is a significant prognostic factor in the lung cancer recurrence.