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Fernando Conrado Abrão
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P1.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 692)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.06-010 - Interaction between Treatment Delivery Delay and Stage on the Mortality from Non-Small Cell Lung Cancer (ID 9093)
09:30 - 16:00 | Presenting Author(s): Fernando Conrado Abrão
- Abstract
Background:
Objective: The aim of this study is to evaluate the effect on the mortality of a delay of more than 2 months in treatment delivery after the diagnosis of non small cell lung cancer (NSCLC).
Method:
We performed a retrospective review of records form patients registered in a prospectively keep database on lung câncer.. patients with malignant lung neoplasms, admitted at a single reference oncology center of public-system health between July 2008 and December 2014. Patients were considered eligible for this study if they were older than 18 years and had not undergone any previous oncology treatment when they were admitted at the institution. The following data were collected from all patients: age, gender, smoking status, histological type, surgical treatment, tumor staging and time from the date when the patient was diagnosed with cancer to the starting date of effective treatment.
Result:
We identified 359 elegible patients. Of these, 278 (77.4%) died during follow-up while 81 (22.6%) were censored. Age, sex and smoking status were not statistically significant predictors of mortality and were not considered for multivariate analysis. Stage of disease, surgical treatment and histological type of lung cancer were predictor of mortality (p< 0.05)). Besides that, in both the crude and adjusted analysis, delayed delivery of treatment was protective for the risk of death, with a crude HR= .75 (.59 - .97; p= .02) and an adjusted HR= .59 (.46 - .77; p<.001). A statistically significant interaction for mortality was observed between timely delivery of treatment and tumor stage (p=.01). The HR for mortality of getting delayed access to treatment according to stage are described: stages I and III, mortality was not significantly different between those that got treatment before or after 2 months from diagnosis (Stage I: HR= 1.24 (.39 – 3.98; p=.71); Stage III: HR= .65 (.38 – 1.1; p=.11)). However, patients with stage II disease who received delayed treatment had a mortality 3 times higher than those that received timely treatment delivery (HR= 3.08 (1.05 – 9.0; p=.04)). On the other hand, stage IV patients that received delayed treatment had a 52% reduction in mortality.
Conclusion:
There was influence of stage at the association between time to start treatment and mortality. About this influence, only the subgroup of stage II NSCLC patients appears to benefit of early treatment.
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P2.10 - Nursing/Palliative Care/Ethics (ID 711)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.10-006 - Prognostic Factors of Mortality and Recurrence of Malignant Pleural Effusion in High-Risk Tumors According to the LENT Score Study (ID 9635)
09:30 - 16:00 | Presenting Author(s): Fernando Conrado Abrão
- Abstract
Background:
The aim of this study was to identify predictors of overall survival (OS) and recurrence after palliative pleural procedures in patients with malignant pleural effusion (MPE) and high-risk tumors according to the LENT Score Study.
Method:
Data was collected from our database between January 2013 and December of 2015 of patients high-risk tumors according to the LENT Score and MPE. All patients were followed-up at least 30 days after the pleural procedure. We studied radiological aspects, biochemical and hematimetric parameters beyond clinical features. To analyze OS, patients were divided into two groups. Group I included OS greater than 30 days and Group II included OS shorter than 30 days. Prognostic factors for pleural recurrence and OS were identified by univariate analysis, using Fisher's exact and Student's T-Test. Subsequently, the significant variables were entered into a multivariate logistic regression analysis (p < 0.05).
Result:
A total of 134 patients were included in the analysis. Median follow-up time for surviving patients was 56 (range 2 to 623) days. High-risk primary tumors included lung 66,4%, gastrointestinal 24,6%, sarcoma 3,7%, urological 3,7% and others 1,5%. There were 44 patients in Group I who had OS shorter than 30 days. Recurrence occurred in 22 patients of the entire cohort. Factors affecting OS in univariate analysis were: procedure, ECOG, albumin, leukocytes, neutrophil to lymphocyte ratio (NRL) e hemoglobin in peripheral blood. Factors affecting recurrence were: procedures, quimiotherapy line (QL), albumin and platelets. At the multivariate analysis in Group I, the type of procedure (therapeutic pleural aspiration – TPA) (p = 0.011), ECOG 3 e 4 (p = 0.004), NLR > 5 (p = 0.037) and leukocytes > 8000 (p = 0.042) were identified as independents predictors of OS. About recurrence, only QL further than first line (p = 0.042) was identified as independent predictor.
Conclusion:
Patients with MPE who underwent TPA, ECOG 3 and 4, with leukocytes > 8000, NLR > 5 were significantly associated with shorter OS, and QL greater than first line was associated with recurrence. The identification of those prognostic factors may assist the choice of the optimal palliative technique for high-tumors risk patients according LENT score study.
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P3.10 - Nursing/Palliative Care/Ethics (ID 726)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.10-001 - Prognostic Factors of Survival in Malignant Pleural Effusion (ID 9647)
09:30 - 16:00 | Presenting Author(s): Fernando Conrado Abrão
- Abstract
Background:
The aim of this study was to identify predictors of overall survival (OS) after pleural palliative procedures in patients with malignant pleural effusion (MPE).
Method:
Data was collected from our database between August 2013 and December of 2016 of patients with MPE. All patients were followed-up at least 30 days after the pleural procedure. Collected data included basic demographics, American Society of Anesthesiologists (ASA) physical status classification, performance status according to the Eastern Cooperative Oncology Group (ECOG) score, number of metastatic sites, hematological parameters, including white blood cells (WBC), number of neutrophils and lymphocytes, neutrophil/lymphocyte ratio (NLR), red blood cells (RBC) and platelets/lymphocyte ratio, in addition to body mass index (BMI) on the day before surgery. The influence of the primary tumor site was also assessed. During the period after the palliative procedure, we evaluated the volume of drained liquid, the type of palliative procedure performed, recurrence of pleural effusion, the presence of neoplastic cells in the pleural fluid, in addition to the biochemical profile including pleural fluid pH, levels of adenosine deaminase (ADA), total protein, albumin, glucose, lactate dehydrogenase (DHL) and the proportion of lymphocytes in pleural fluid. We also evaluated the presence of pleural thickening and pulmonary infiltrate through chest computed tomography. To analyze OS, patients were divided into two groups. Group I included OS greater than 30 days and Group II included OS shorter than 30 days. Prognostic factors for survival were identified by univariate analysis, using Fisher's exact and Student's T-Test. Subsequently, the significant variables were entered into a multivariate logistic regression analysis (p < 0.05).
Result:
A total of 208 patients were included in the analysis, 36,5% were male and the median age was 62 years. Median follow-up time for overall surviving was 127 days. The primary tumors were lung 39,9%, breast 29,3%, gastrointestinal 13%, gynecological 8,7% and others 9,1%. Factors affecting OS in univariate analysis were: procedure, ECOG, pulmonary infiltrate, albumin, protein, neutrophil, hematocrit and hemoglobin in peripheral blood. At the multivariate analysis, albumin (p=0.03), ECOG 3 e 4, hematocrit and pulmonary infiltrate with p<0.001 were identified as independents predictors of OS.
Conclusion:
Patients with MPE who presented pulmonary infiltrate, albumin < 2,5, hematocrit < 35, ECOG 3 and 4 were significantly associated with shorter survival. The identification of those prognostic factors may assist the choice of the optimal palliative support.
