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S. Otsuka
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MA06 - Locally Advanced NSCLC: Risk Groups, Biological Factors and Treatment Choices (ID 379)
- Event: WCLC 2016
- Type: Mini Oral Session
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:P. Van Houtte, M. Zemanová
- Coordinates: 12/05/2016, 16:00 - 17:30, Strauss 2
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MA06.01 - Overall Survival Characterization of Incidental N2 Non-Small Cell Lung Cancer over 14 Years at a Single Canadian Institution (ID 4751)
16:00 - 17:30 | Author(s): S. Otsuka
- Abstract
- Presentation
Background:
Incidental stage IIIA non-small cell lung cancer (NSCLC) cases have positive N2 mediastinal lymph node involvement discovered at the time of surgery, resulting in stage reclassification. These patients represent a small group within the stage III patient spectrum with limited data regarding their outcome. This study’s aim is to characterize the survival of incidental stage IIIA disease and compare these outcomes to patients diagnosed with stage II and IIIA disease.
Methods:
Using the Glans-Look Lung Cancer database and electronic patient charts, a retrospective review identified patients consulted at the Tom Baker Cancer Center from 1999 to 2012 who were defined as incidental stage III NSCLC. Their outcome was compared with stage II patients who underwent resection and stage IIIA patients treated with concurrent chemotherapy and radiation (CCR). These groups were selected for comparison because they represent patients who received the recommended standard of care for their respective diagnosis. A Kaplan-Meier analysis was conducted to compare overall survival (OS) among the groups.
Results:
Fifty-eight incidental stage III NSCLC patients were identified: median age was 63 years (SE ±10.3), 46.6% male, and 63.8% received adjuvant therapy. There were 225 individuals treated with CCR; median age 64 years (SE ±9.0), 56.0% male. The stage II group contained 248 individuals, the median age was 64 years (SE ±10.2), 53.6% were males, and 30.6% received adjuvant therapy. The OS of the incidental group was 47.4 months (95% CI 20.0-74.7). The OS for patients treated with CCR only was 24.0 months (95% CI 20.8-27.2) and 55.3 months (95% CI 43.7-66.9) for stage II resected cases. There was a significant difference in OS between CCR-treated stage IIIA and incidental cases (p = .001) but not between stage II and incidental (p = .264). The five-year survival rates were 44.6% (SE ±6.5) for incidental IIIA, 21.0% (SE ±2.7) for CCR-treated IIIA, and 46.9% (SE ±3.2) for resected stage II.
Conclusion:
This study demonstrates that incidental stage IIIA-N2 patients are a distinct group whose median OS closely resembled stage II patients. The benefit of resection for stage IIIA patients suggests that the traditional influence of stage in dictating treatment is changing. Further investigation is needed to identify which stage IIIA patients benefit the most. Ongoing analysis will include a comparison of progression-free survival between the three groups, impact assessment of post-operative treatment on OS, and a description of the diagnostic process evolution over time leading to an incidental N2 diagnosis.
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P1.06 - Poster Session with Presenters Present (ID 458)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.06-022 - Clinical Characteristics of Survival Outliers in Stage IV Adenocarcinoma Lung Cancer Patients (ID 4304)
14:30 - 15:45 | Author(s): S. Otsuka
- Abstract
Background:
Lung cancer is the leading cause of cancer deaths among men and women in Canada. Many lung cancer patients are diagnosed at advanced stages of disease, which is associated with poor survival outcomes. The mean survival of stage IV non-small cell lung cancer (NSCLC) patients is typically less than 12 months; however, there appears to be a small subset of patients with advanced disease that live substantially longer than the norm. Our study aims to determine whether certain clinical characteristics correlate with longer survival in stage IV NSCLC patients.
Methods:
Data on 1803 stage IV NSCLC patients (1291 adenocarcinoma, 512 squamous cell carcinoma) from 1999-2011 were extracted from the Glans Look Lung Cancer database. Adenocarcinoma data is presented here; squamous cell carcinoma data analysis is ongoing. Clinical characteristics such as age, gender, ethnicity, smoking history, histology, molecular testing, metastatic disease, treatments, and socioeconomic factors were compared between survival outliers and patients with average survival. Survival outliers were defined as those patients who lived > 5 years, or greater than 2 standard deviations from mean survival (42.1 months).
Results:
In the survival outlier group, there were 25 patients who lived >5 years, and 59 who lived >42.1 months. Survival outliers included a higher percentage of females, had a smaller smoking history, smaller tumour size at diagnosis, received more treatment lines, and had lower metastatic disease burden at diagnosis (P<0.05 in the outlier group with survival >42.1 months). Upon further characterization of metastatic disease, there appears to be survival outliers associated with no liver metastases and less sites of metastases at diagnosis, as well as with stage M1a disease compared to stage M1b.
Conclusion:
Adenocarcinoma patients with localized and lower metastatic disease burden and no liver metastases at the time of diagnosis appeared to live longer than their counterparts. Further statistical analysis is ongoing to determine the significance of other clinical characteristics with respect to survival. The present study will help us better understand the importance of various clinical parameters and their association with survival, in hopes of improving outcomes for lung cancer patients in the future.
