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V. Puri
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-047 - Early Mortality in Patients with Non-Small Cell Lung Cancer Undergoing Adjuvant Chemotherapy (ID 5523)
14:30 - 15:45 | Author(s): V. Puri
- Abstract
Background:
Although adjuvant chemotherapy improves survival in patients with completely resected non-small-cell lung cancer (NSCLC) compared to surgery alone, it is also associated with potentially disabling or lethal adverse events. Since there is limited information on the early mortality among patients undergoing adjuvant chemotherapy, we used the National Cancer Data Base (NCDB) to calculate the percentage of deaths within the first 6 months from starting chemotherapy.
Methods:
The NCDB was queried for patients aged 18 or older, diagnosed with stage IB to IIIA NSCLC (AJCC 7[th] edition) from 2004 to 2012, who underwent surgery with negative margins followed by multi-agent chemotherapy, starting within 120 days from the surgical resection. Patients who received radiation therapy were excluded. Age groups were divided into <50, 51-60, 61-70, 71-80 and >80 years. Early mortality from months 1 to 6 were calculated and multivariate logistic regression was performed to identify clinical variables independently associated with mortality at six months from the date of initiation of adjuvant chemotherapy.
Results:
A total of 19,791 patients met the eligibility criteria. The median age was 65 (range 19-89). The percentage of deaths at 1, 2, 3, 4, 5 and 6 months were 0.6%, 1.3%, 1.9%, 2.6%, 3.3% and 4.2% respectively. The percentages of death at 6 months for each age group from < 50 years to > 80 years were 2.7%, 3.2%, 4.1%, 5.3% and 7.8% respectively. Factors independently associated with increased 6-month mortality included increased age, male gender, higher Charlson-Deyo co-morbidity score (CDCS), type of surgery, length of stay (LoS) > 6 days and 30-day readmission (Table).
Conclusion:
There is a high risk for early mortality among patients undergoing adjuvant chemotherapy for NSCLC, particularly in patients older than 70, with high co-morbidity score and a more complicated post-operative period.Table. Multivariable analysis
Variable OR (95% CI) P-value Age ≤ 50 Reference Reference 51-60 1.08 (0.74-1.60) 0.68 61-70 1.33 (0.91-1.95) 0.15 71-80 1.59 (1.06-2.38) 0.03 > 80 2.27 (1.29-3.98) 0.004 Gender Male Reference Reference Female 0.70 (0.59-0.82) < 0.001 CDCS 0 Reference Reference 1 1.13 (0.95-1.34) 0.15 2 1.58 (1.26-1.98) < 0.001 Surgery Sub-lobar Reference Reference Lobectomy 0.72 (0.53-0.97) 0.03 Pneumonectomy 0.97 (0.68-1.39) 0.87 Stage IB Reference Reference II 1.29 (1.04-1.59) 0.02 IIIA 2.28 (1.81-2.87) < 0.001 LoS ≤ 6 days Reference Reference > 6 days 1.24 (1.06-1.46) 0.008 30-day readmission No Reference Reference Yes 1.54 (1.20-1.99) 0.001
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P2.03a - Poster Session with Presenters Present (ID 464)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03a-002 - Patterns of Chemotherapy Use and Overall Survival (OS) of Patients with Stage IV Squamous Lung Cancer (SCC) (ID 5216)
14:30 - 15:45 | Author(s): V. Puri
- Abstract
Background:
Chemotherapy is standard of care for patients with metastatic SCC. There is limited information on the use and outcome of patients with metastatic SCC who receive chemotherapy. We used the National Cancer Data Base (NCDB) to investigate the use and survival of patients receiving chemotherapy for stage IV SCC.
Methods:
The NCDB was queried for patients≥ 18 years, diagnosed with stage IV SCC between 2004-2013 for whom chemotherapy data was available. The percentage of patients receiving chemotherapy within 2 months of diagnosis was calculated. Patients were stratified by age (<50, 50-70 and >70 years), Charlson-Deyo comorbidity score (0, 1 and 2), gender, and period of diagnosis (2004-2006, 2007-2009, 2010-2012) to evaluate patterns of chemotherapy use. Median, 1-year and 2-year OS were calculated for patients that received chemotherapy using Kaplan Meier method.
Results:
Among the 86,200 patients that met the eligibility criteria, 40,147 (46.6%) patients received chemotherapy, which included single agent (n=3,912; 9.7%) multiagent (n=32,737;81.5%) and number of agents unknown (n=3,498;8.7%). A total of 46,053 (53.43%) patients did not receive chemotherapy due to chemotherapy not recommended (n=5,397; 11.7%), patient refusal (n=6,119; 13.3%) and other/unknown reasons (n=34,537; 75%). Patients receiving multi-agent chemotherapy were younger than those receiving single agent chemotherapy (65.6 vs 71.5 years). Chemotherapy use declined with increase in comorbidity score (50.4% for score of 0, 44% for score of 1 and 36.2% for score of 2). The median, 1-year and 2-year OS for patients receiving chemotherapy were 7.5 months, 30.6% and 11.8% respectively (Table).OS for patients receiving chemotherapy by risk factor
Risk factor Median survival (months) 1 year OS 2 year OS Age <50 7.6 29.7% 11.5% 50-70 7.8 32.0% 12.4% >70 7.0 28.5% 10.8% Gender Male 7.3 29.0% 10.7% Female 7.9 33.7% 13.8% Year of diagnosis 2004-2006 7.3 28.8% 10.7% 2007-2009 7.5 31.0% 11.8% 2010-2013 7.7 31.6% 12.7% Charlson-Deyo comorbidity score 0 8.0 32.6% 12.7% 1 7.1 28.4% 10.6% 2 6.3 24.9% 9.2% All patients 7.5 30.6% 11.8%
Conclusion:
Most patients with metastatic SCC do not receive chemotherapy. The OS for patients with metastatic SCC remains poor, especially in patients over the age of 70, in men and those with multiple comorbidities.
