WCLC 2025 - Posters & ePosters-P2.06.81 Circulating Tumour Cells, Spread Through Air Space and Lymph-Nodal Micrometastasis in Surgically Resected Early-Stage NSCLC

P2.06.81 Circulating Tumour Cells, Spread Through Air Space and Lymph-Nodal Micrometastasis in Surgically Resected Early-Stage NSCLC

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This monocentric prospective study investigated the relationship between circulating tumor cells (CTCs), spread through air spaces (STAS), and lymph node micrometastasis in 57 patients with early-stage (clinical IA-IIA) non-small cell lung cancer (NSCLC) undergoing surgical resection. After exclusions, 52 patients were followed postoperatively.<br /><br />Key findings include that 55.8% of patients had detectable CTCs, with 51.9% showing STAS. No lymph node micrometastases were found. There was a notable trend toward an association between CTC presence and STAS (p=0.065), and CTCs correlated significantly with high-grade adenocarcinoma patterns (p=0.047). Postoperative CTC counts were higher on average than preoperative counts but were not significantly influenced by vascular resection order (vein-first vs artery-first). A small, exploratory observation suggested that artery-first vascular dissection might reduce postoperative CTC levels, though this requires further confirmation due to limited sample size.<br /><br />The study cohort had balanced gender representation, an average age of 71.4, and predominantly consisted of patients with adenocarcinoma (82.7%). Most underwent lobectomy (75%), primarily via robotic-assisted thoracic surgery (67.3%). Recurrence risk after surgery remains a clinical challenge despite early-stage diagnosis, motivating this research into biological markers.<br /><br />The authors conclude this study is among the first to link circulating tumor cells to STAS, both markers associated with aggressive tumor biology and potential recurrence risk in early-stage NSCLC. However, surgical factors showed no strong association with CTC presence or spread. Larger studies with longer follow-up are needed to validate these associations and assess their prognostic impact in improving surgical and systemic treatment strategies.

Asset Subtitle

Pietro Bertoglio

Meta Tag

Speaker Pietro Bertoglio

Topic Pathology and Biomarkers

Keywords

circulating tumor cells

CTCs

spread through air spaces

STAS

lymph node micrometastasis

non-small cell lung cancer

NSCLC

early-stage lung cancer

adenocarcinoma

vascular resection order