Song Gao1,2, Seth Stein1, Elena N Petre1, Waleed Shady1, Jeremy C Durack1, Carole Ridge1,3, Prasad Adusumilli4, Natasha Rekhtman5, Stephen B Solomon1, Etay Ziv6. 1. Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, Howard-118, 1275 York Ave, New York, NY, 10065, USA. 2. Interventional Therapy Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education Beijing), Peking University Cancer Hospital and Institute, Beijing, 100142, China. 3. Department of Radiology, Mater Misericordiae, University Hospital, Dublin 7, Ireland. 4. Thoracic Surgery Service, Memorial Sloan-Kettering Cancer Center, Howard-118, 1275 York Ave, New York, NY, 10065, USA. 5. Pathology Diagnostic Service, Memorial Sloan-Kettering Cancer Center, Howard-118, 1275 York Ave, New York, NY, 10065, USA. 6. Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, Howard-118, 1275 York Ave, New York, NY, 10065, USA. zive@mskcc.org.
Abstract
BACKGROUND: To investigate whether histologic subtyping from biopsies can predict local recurrence after thermal ablation for lung adenocarcinoma. METHODS: Patients treated with CT-guided thermal ablation for lung adenocarcinoma that had pre-ablation needle biopsy with analysis of histologic components were identified. Age, gender, smoking status, treatment indication (primary stage 1 tumor versus salvage), histologic subtype, ground-glass radiographic appearance, tumor size, ablation modality, and ablation margin were evaluated in relation to time to local recurrence (TTLR). Cumulative incidence of recurrence (CIR) was calculated using competing risks analysis and compared across groups using Fine and Grey method with clustering. Multivariate analysis was conducted with stepwise regression. RESULTS: There were 53 patients with 57 tumors diagnosed as adenocarcinoma on pre-ablation biopsy and with histologic subtype analysis. Of these, 19% (11) had micropapillary components, 14% (8) had solid components, and 26% (15) had micropapillary and/or solid components. In the univariate analysis, solid (subdistribution hazard ratio [SHR] = 4.04, p = 0.0051, 95% confidence interval [CI] = 1.52-10.7), micropapillary (SHR = 3.36, p = 0.01, CI = 1.33-8.47), and micropapillary and/or solid components (SHR = 5.85, p = 0.00038, CI = 2.21-15.5) were significantly correlated with shorter TTLR. On multivariate analysis, the presence of micropapillary and/or solid component (SHR = 11.4, p = 0.00021, CI: 3.14-41.3) was the only independent predictor of TTLR. The 1-, 2-, and 3-year CIR in patients with micropapillary and/or solid components was 33, 49, and 66% compared to 5, 14, and 18% in patients with no micropapillary or solid components on biopsy specimens. CONCLUSION: Micropapillary and/or solid histologic components identified in pre-ablation biopsy are associated with shorter TTLR after thermal ablation of lung adenocarcinoma.
BACKGROUND: To investigate whether histologic subtyping from biopsies can predict local recurrence after thermal ablation for lung adenocarcinoma. METHODS:Patients treated with CT-guided thermal ablation for lung adenocarcinoma that had pre-ablation needle biopsy with analysis of histologic components were identified. Age, gender, smoking status, treatment indication (primary stage 1 tumor versus salvage), histologic subtype, ground-glass radiographic appearance, tumor size, ablation modality, and ablation margin were evaluated in relation to time to local recurrence (TTLR). Cumulative incidence of recurrence (CIR) was calculated using competing risks analysis and compared across groups using Fine and Grey method with clustering. Multivariate analysis was conducted with stepwise regression. RESULTS: There were 53 patients with 57 tumors diagnosed as adenocarcinoma on pre-ablation biopsy and with histologic subtype analysis. Of these, 19% (11) had micropapillary components, 14% (8) had solid components, and 26% (15) had micropapillary and/or solid components. In the univariate analysis, solid (subdistribution hazard ratio [SHR] = 4.04, p = 0.0051, 95% confidence interval [CI] = 1.52-10.7), micropapillary (SHR = 3.36, p = 0.01, CI = 1.33-8.47), and micropapillary and/or solid components (SHR = 5.85, p = 0.00038, CI = 2.21-15.5) were significantly correlated with shorter TTLR. On multivariate analysis, the presence of micropapillary and/or solid component (SHR = 11.4, p = 0.00021, CI: 3.14-41.3) was the only independent predictor of TTLR. The 1-, 2-, and 3-year CIR in patients with micropapillary and/or solid components was 33, 49, and 66% compared to 5, 14, and 18% in patients with no micropapillary or solid components on biopsy specimens. CONCLUSION: Micropapillary and/or solid histologic components identified in pre-ablation biopsy are associated with shorter TTLR after thermal ablation of lung adenocarcinoma.
Entities:
Keywords:
Histologic subtype; Local recurrence; Lung ablation; Micropapillary and solid
Authors: S Nahum Goldberg; Clement J Grassi; John F Cardella; J William Charboneau; Gerald D Dodd; Damian E Dupuy; Debra A Gervais; Alice R Gillams; Robert A Kane; Fred T Lee; Tito Livraghi; John McGahan; David A Phillips; Hyunchul Rhim; Stuart G Silverman; Luigi Solbiati; Thomas J Vogl; Bradford J Wood; Suresh Vedantham; David Sacks Journal: J Vasc Interv Radiol Date: 2009-07 Impact factor: 3.464
Authors: Damian E Dupuy; Hiran C Fernando; Shauna Hillman; Thomas Ng; Angelina D Tan; Amita Sharma; William S Rilling; Kelvin Hong; Joe B Putnam Journal: Cancer Date: 2015-06-19 Impact factor: 6.860
Authors: Etay Ziv; Joseph P Erinjeri; Hooman Yarmohammadi; F Edward Boas; Elena N Petre; Song Gao; Waleed Shady; Constantinos T Sofocleous; David R Jones; Charles M Rudin; Stephen B Solomon Journal: Radiology Date: 2016-07-19 Impact factor: 11.105
Authors: Waleed Shady; Elena N Petre; Mithat Gonen; Joseph P Erinjeri; Karen T Brown; Anne M Covey; William Alago; Jeremy C Durack; Majid Maybody; Lynn A Brody; Robert H Siegelbaum; Michael I D'Angelica; William R Jarnagin; Stephen B Solomon; Nancy E Kemeny; Constantinos T Sofocleous Journal: Radiology Date: 2015-08-12 Impact factor: 11.105