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J.A. Méndez

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    Immunotherapy and next-generation TKIs: From second to frontline treatment (ID 55)

    • Event: ELCC 2018
    • Type: Poster Discussion session
    • Track:
    • Presentations: 1
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      137PD - Prognostic factors in oligometastatic non-small-cell lung cancer (OM-NSCLC) (ID 616)

      07:45 - 09:00  |  Author(s): J.A. Méndez

      • Abstract
      • Slides

      OM-NSCLC represents a distinct prognostic group within stage IV lung cancer. An increase in overall survival (OS) has been suggested with ablative (surgery or radiotherapy) therapy. We performed an analysis of clinical factors influencing outcome in a series of patients (pts) with OM-NSCLC treated in a tertiary hospital.

      OM-NSCLC pts (defined as ≤3 metastatic lesions at diagnosis) diagnosed between Jan-2012 and Dec-2016 were included in the analysis. Median OS was calculated with the Kaplan-Meier method. The association between clinical and pathological factors and OS was determined using uni- (UV) and multivariable (MV) Cox regression models. Variables with a p-value <0.01 in UV analysis were included in the MV model.

      84 pts were identified: 25 pts squamous histology (29.8%), 58 adenocarcinoma (58%) and 1 (1.2%) undifferentiated carcinoma. 11 pts (13%) were EGFR-mutation positive. Most patients presented with one (78.3%) or two (20.5%) metastatic sites: CNS (39.2%), bone (29.8%), lung (17.9%), adrenal (11.9%) and liver (10.7%). 57 pts (67.9%) underwent local treatment (8.8% surgery, 70.2% radiotherapy, both 21.2%) before (68.2%) or during (49.1%) chemotherapy. Median follow-up was 10.5 months with a median OS of 15.8 months (95CI%:8.9–22.7). In MV OS analysis, only T-stage (p = 0.012) and histology (p = 0.006) were significantly associated with OS (Table).Table:UV and MV Cox-regression Models

      VariableHR (CI95%)p-valorHR (CI95%)p-valor
      Histology0,32 (0.18–0.58)<0.001*0.42 (0.23–0.78)0.006
      Sex0,44 (0.19–1.03)0.059*0.52 (0.22–1.25)0.142
      Smoking1,27 (0.79–2.05)0.320
      T stage1,47 (1.16–1.89)0.002*1.44 (1.09–1.92)0.012
      N stage1,01 (0.99–1.02)0.496
      N° of metastasis1,32 (0.72–2.41)0.366
      Site of metastasis
       Lung0.80 (0.41–1.58)0.522
       Adrenal gland0.91 (0.49–1.69)0.767
       CNS0.89 (0.55–1.45)0.647
       Liver1.36 (0.76–2.44)0.302
       Bone1.45 (0.91–2.33)0.118
       Other1.05 (0.42–2.63)0.916
      Local treatment (yes/no)0.42 (0.24–0.76)0.004*0.61 (0.33–1.12)0.115

      Ablative therapy in OM-NSCLC pts was not associated with higher OS. Only a lower initial T-stage in the primary tumor and adenocarcinoma histology could represent a favorable prognosis. The optimal management of NSC-OM patients will require robust data from well-designed prospective clinical trials.

      Clinical trial identification:

      Legal entity responsible for the study:
      Medical Oncology, Hospital La Fe.

      Has not received any funding

      All authors have declared no conflicts of interest.

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