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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Presentations: 1
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
101P - Overtreatment in early lung cancer: Survival is independent of pathological confirmation (ID 302)
12:30 - 13:00 | Author(s): G. Fastner
Lung cancer causes 27% of all cancer deaths. About 10% of the patients are diagnosed in UICC stages I-IIa. Although pathological proof is compulsory before cancer treatment, some patients are unable or reluctant to undergo invasive diagnostic procedures. Nonetheless, these individuals are frequently treated similarly to patients with histologically confirmed disease, which might bear the risk of treating indolent or even benign tumors. A SEER-analysis  found a significantly better OS in patients with clinically diagnosed tumors without pathological confirmation, which made the authors conclude that patients with such lesions are probably overtreated. We analysed our own data as a non-selected single centre cohort to compare survival data of patients with and without pathological proof.
163 patients with NSCLC UICC I-IIa irradiated between 2002 and 2016 were eligible. Of these, 123 patients had pathological proof of disease. In these cases, irradiation treatment was administered in the same way as if these patients had a confirmed malignant disease. In accordance with international guidelines, the decision was based on the patient's age and smoking history, new or growing nodule on CT and positive PET-scan.
Both overall (OS) and cancer specific survival (CSS) did not differ between patients with pathological confirmation compared with those without: median OS 40,1 (range: 0,3–147,5) months versus 39,4 (range: 0,5–162) months (p = 0,958), median CSS 51,7 (3,7–129,5) months versus 113,4 (0,5–162) months (p = 0,585). Patients with pathological confirmation had higher UICC stage (p-value = 0,002) and received more chemotherapy (p-value < 0,001).
Our study revealed no difference in OS and CSS for irradiated stage I-IIa lung cancer patients with and without histological confirmation, thus indicating a comparable benefit from treatment. A main reason probably lies in the strict adherence to a modern diagnostic work-up including PET-CT scan for all patients. Shaikh T (2016) Absence of Pathological Proof of Cancer Associated with Improved Outcomes in Early-Stage Lung Cancer. J Thorac Oncol 11 (7):1112–1120.
Clinical trial identification:
Legal entity responsible for the study:
Paracelsus Medical University, University Hospital Salzubrg, Department of Radiation Oncology
Has not received any funding
All authors have declared no conflicts of interest.
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