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R. Báez-Saldaña
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ORAL 30 - Community Practice (ID 141)
- Event: WCLC 2015
- Type: Oral Session
- Track: Community Practice
- Presentations: 1
- Moderators:P.S.S. Kho, R. Jotte
- Coordinates: 9/08/2015, 16:45 - 18:15, Mile High Ballroom 2c-3c
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ORAL30.07 - Different Mutation Profiles and Clinical Characteristics Among Hispanic Patients with NSCLC Could Explain The 'Hispanic Paradox' (ID 748)
16:45 - 18:15 | Author(s): R. Báez-Saldaña
- Abstract
- Presentation
Background:
Sixteen percent of the U.S. population is Hispanic, predominantly of Mexican ancestry. Recently, two independent American reports demonstrated a higher overall survival (OS) in Hispanic populations compared with non-Hispanic-white populations (NHW) in patients with non-small-cell lung cancer (NSCLC) diagnosis. The latter even when most of the Hispanics are diagnosed at advanced stages of disease and are low-income patients. The aim of our study was to analyze the clinical, pathological, and molecular characteristics as well as the outcomes in a cohort of NSCLC Hispanic patients from the National Cancer Institute of Mexico that could explain this "Hispanic Paradox".
Methods:
A cohort of 1260 consecutive NSCLC patients treated at the National Cancer Institute of Mexico from 2007-2014 was analyzed. Their clinical- pathological characteristics, the mutation-status of EGFR and KRAS and the prognosis were evaluated.
Results:
Patients presented with stages of disease: II (0.6%), IIIa (4.8%), IIIb (18.4%) and IV (76.3%). NSCLC was associated with smoking in 56.5% of the patients (76.7% of male vs. 33.0% of female patients). Wood smoke exposure (WSE) was associated with 37.2% of the cases (27.3% in men vs. 48.8% in women). The frequency of EGFR mutations was 28.1% (18.5% in males vs. 36.9% in females, p<0.001) and the frequency for KRAS mutations was 10.2% (10.3% men vs. 10.1% in women p= 0.939). The median OS for all patients was 23.0 months [CI95% 19.4-26.2], whereas for patients at stage IV, it was 20.1 months [CI 95% 16.5-23.7]. The independent factors associated with the OS were as follows, the ECOG Performance Status, stage of disease, EGFR and KRAS mutation status.
Conclusion:
The high frequency of EGFR mutations and low frequency of KRAS mutations in Hispanic populations and different prevalence in lung cancer-related-developing risk factors compared with Caucasian populations, such as the lower frequency of smoking exposure and higher WSE, particularly in women, might explain the prognosis differences between foreign-born-Hispanics, US-born-Hispanics and NHWs.
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-019 - Accuracy of Percutaneous Closed Pleural Biopsy in Thoracic Malignancies (ID 54)
09:30 - 17:00 | Author(s): R. Báez-Saldaña
- Abstract
Background:
Recently there has been some controversy about the value of percutaneous closed pleural biopsy (PCPB) as a diagnostic procedure for establishing the etiology of pleural effusion. Our objective was to assess the accuracy of percutaneous closed pleural biopsy as a diagnostic procedure for lung cancer and mesothelioma in patients with pleural effusion.
Methods:
We performed a prospective study of all individuals who underwent percutaneous closed pleural biopsy, using Cope needle or Abram’s needle in order to establish the etiology of pleural effusion, during a 8/year period in a refering hospital of respiratory diseases in Mexico City. The identification of patients who underwent closed pleural biopsy was obtained from the anatomopathological registries. The information of each patient was obtained by medical record review. In this study, when the pleural biopsy did not establish the definite diagnostic, we used as a gold standard other procedures such as thoracoscopy, open lung/pleural biopsy, fiberoptic bronchoscopy, adenosine deaminase and/or microbiological tests. All cases were followed up at least three months through medical record review and direct contact with the patient. With 2x2 table we determined the accuracy of PCPB.
Results:
A total of 1034 pleural biopsies were performed. Malignancy was identified in 466 (45.07%) of whom 252 (24.37%) had adenocarcinoma,105 (10.16%) mesothelioma, cancer not differentiated 28 (2.71%), epidermoid 5 (0.48%) small cells cancer 19 (1.84%), giant cells cancer 6 (0.58%), limphomas 11 (1.06%) and others malignancies 40 (3.87%). 116 (%) cases of pleural tuberculosis and 2 (0.19%) parapneumonicos. 378 (36.56%) biopsies were non/specific inflammatory. 171 (19.81%) were excluded to the analysis due to 72 (6.96%) obtaining no pleural tissue and in 99 (9.57%) we can not obtain case information. A total of 863 biopsies were analysed to asses the accuracy.Indicator Lung cancer and other malignancies Mesothelioma Sensitivity % (CI 95%) 77 (74-79) 81 (78-83) Specificity % (CI 95%) 98 (97-99) 100 Positive predictive value % (CI 95%) 99 (98-100) 100 Negative predictive value % (CI 95%) 66 (63-70) 97 (96-98) Likelihood ratio positive 38.5 81 Likelihood ratio negative 0.23 0.19 Prevalence % (CI 95%) 68 (65-71.3) 15 (13-17)
Conclusion:
This is a valid, available, accurate and precise diagnostic test which can be applied in patients with pleural effusion to establish cancer or tuberculosis diagnostic. The percutaneous closed pleural biopsy in this setting is useful in our practice due to produces big change from pre-test to post-test probability.
