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Ying Chen
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-074 - Wait and See: A Favorable Alternative for R-M1a and S-M1a NSCLC Patients (ID 10304)
09:00 - 16:00 | Presenting Author(s): Ying Chen
- Abstract
Background:
Intrathoracic dissemination M1a disease has been reported to be a distinct lung cancer with favorable prognosis and contraindicated surgery may be beneficial to patients with NSCLC. This study aims to investigate treatments of r-M1a and s-M1a in real world and explore which kind of resection type of lung benefits s-M1a patients.
Method:
Patient characteristics, pathology, gene profiles and treatment were respectively collected for lung cancer patients who were diagnosed as r-M1a or s-M1a stage IV disease. Different therapies were evaluated by comparing progression free survival (PFS) and overall survival (OS) by Kaplan-Meier. A cox proportional hazards regression model was applied to evaluate the prognosis factors. Statistical analysis was performed in all subgroups.
Result:
Overall, 2304 consecutive lung cancer patients receiving thoracotomies at Guangdong general hospital were retrospectively analyzed. Eighty r-M1a patients (3.47% of all patients) and Seventy-three s-M1a patients (3.17% of all patients) were enrolled. Difference was observed in two groups among gene profiles and treatment. Compared to r-M1a group, s-M1a group contained more patients with EGFR mutation (18.3% VS 32.7%, P<0.001) and ALK overexpression (0.7% VS 1.3%, P=0.005), a higher proportion chemotherapy patients and lower local treated patients (19.0% VS 24.2%, 7.5% VS 0%, P=0.008). Median PFS of r-M1a and s-M1a patients in chemotherapy group (66, 43.14%), targeted therapy group (33, 21.57%), local treatment group (11, 7.19%) and wait-and-see group (43, 28.1%) were 14.7, 27.5, 39.3 and 44.1 months, respectively [95% confidence interval (CI),19.15-28.05; P<0.001. local treatment group VS wait and see group, P=0.924]. And median OS was 52.2, 47.9, 59.4 and 71.7 months, respectively [95% confidence interval (CI), 47.86-61.95; P=0.208]. In addition, no difference between lobectomy and limited resection was observed in patients with s-M1a in PFS [median 21.9 months, 95% confidence interval (CI),17.59 to 26.22; P=0.738] and OS [median 42.6 months, 95% confidence interval (CI),30.89 to 54.25; P=0.944]. Cox regression analysis revealed group (r-M1a VS s-M1a) and pathology were the independent prognostic factors.
Conclusion:
Wait and see strategy may be a favorable alternation for r-M1a and s-M1a patients with NSCLC. For s-M1a NSCLC patients, limited resection of lesions was recommended compared to lobectomy.
