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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
125P - Brain metastases in patients with stage N2 non-small cell lung cancer (ID 347)
12:30 - 13:00 | Author(s): P. McLoone
At diagnosis, 60% of NSCLC patients (pts) have potentially curable locally advanced disease with N0, N1 or N2 lymph node status. Guidelines recommend surgical resection of locally advanced NSCLC followed by adjuvant chemotherapy (SIGN 370). The selection of pts for curative treatment requires a PET scan and pathological nodal staging. Accurate clinical staging of lung cancer ensures best treatment. NICE guidelines recommend consideration of brain imaging in pts selected for treatment with curative intent especially if N2 disease is diagnosed. In clinical practice, many relapse within 1 year despite combination treatment. Brain metastases (mets) are common in NSCLC but there are now more treatment options available. We investigated the frequency of brain mets in pts with post-operative pN2 (pathological N2) disease.
A retrospective audit of West of Scotland Cancer Network was performed of pts with pN2 NSCLC between September 2011 and November 2016. Data collection included demographics, staging investigations, and clinical outcomes using electronic patient records.
We identified 169 NSCLC pts (86 females, 83 males) with pN2 disease. Clinical staging showed 73 pts (43%) cN0, 42 (25%) cN1 and 53 (31%) cN2. 32 pts (19%) had pre-treatment brain imaging. This was higher among pts with cN2 disease (34%). Imaging modality was primarily CT, with MRI used for 9 pts (28%). Follow-up imaging included brain in another 12 (8%). Distant relapse occurred within 3 months of treatment for 11 pts of whom 2 had symptomatic brain mets. Overall 84 (50%) pts experienced distant relapse of which 23% (19/84) had brain mets. Median overall survival of all pts was 25.3 (95%CI 18.5–29.8) months. There was no statistically significant difference in the survival of pts with brain mets compared to other distant mets; median survival 20.3 (8.1–25.3) months vs 17.8 (14.5–21.8) months respectively, log-rank test p = 0.56.
This audit shows that only 34% of cN2 pts underwent pre-operative brain imaging. 1% relapsed within 3 months of surgery with brain mets and overall 23% were diagnosed with brain mets. The median overall survival for this group is comparable with the published series and there was no survival difference between pts with brain mets and other distant metastatic disease.
Clinical trial identification:
Legal entity responsible for the study:
NHS Greater Glasgow and Clyde
Has not received any funding
All authors have declared no conflicts of interest.