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STS 2013: Identifying Small, High-Risk Lung Tumors

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The Particulars: Currently, there is no reliable method for identifying pathologically staged, node-negative non-squamous non-small cell lung cancers (NSCLC) smaller than 2 cm (T1a). As adoption of low-dose CT screening rapidly increases, it is possible that a novel molecular assay may help detect T1a node-negative tumors early.
Data Breakdown: Investigators conducted a validation study in 269 NSCLC patients who underwent resection of T1a node-negative tumors, analyzing a novel molecular assay. Overall post-surgical survival rates were 83%, 69%, and 52% in low-, intermediate-, and high-risk groups, respectively. Results were similar when analysis was restricted to tumors 1 cm or smaller. The hazard ratio associated with the prognostic assay high-risk category was 3.78.
Take Home Pearls: A novel molecular assay appears to reliably identify patients with T1a node-negative tumors at up to 50% risk of mortality. Such identification may help maximize early detection of NSCLC tumors with low-dose CT screening.

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