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Matthew Eric Callister
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MS16 - Implementation of Lung Cancer Screening (ID 795)
- Event: WCLC 2018
- Type: Mini Symposium
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 13:30 - 15:00, Room 206 F
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MS16.05 - Optimal Approach to Integrate Smoking Cessation into Screening Program (ID 11472)
14:30 - 14:45 | Presenting Author(s): Matthew Eric Callister
- Abstract
- Presentation
Abstract not provided
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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P2.16-16 - SABRTOOTH: A Fasibility Study of SABR Versus Surgery in Patients with Peripheral Stage I NSCLC Considered to be at Higher Risk for Surgery. (ID 13679)
16:45 - 18:00 | Author(s): Matthew Eric Callister
- Abstract
Background
Stage I NSCLC is curable by surgery and Stereotactic Ablative Radiotherapy (SABR). Many patients have co-morbidities that place them at higher risk of surgical complications. For such patients it is unknown whether the potential benefits of surgery are outweighed by the risks since published randomised trials comparing surgery with SABR have been underpowered. The SABRTooth study was designed to determine the feasibility of randomising patients between the two treatments and thus performing a larger RCT.
a9ded1e5ce5d75814730bb4caaf49419 Method
Four thoracic oncology centres and a referral site participated. Patients with peripheral (>2cm from the main airways) stage T1-T2bN0M0 NSCLC were considered for study entry. Patients at higher risk were identified using several criteria including Thoracoscore and the Nottingham Risk Score and confirmed by multidisciplinary team consensus.
Eligible patients were approached by a respiratory physician and research nurse, consented and randomised (1:1) before consulting a surgeon or oncologist. Surgery was preferably by lobectomy with lymph node sampling/resection although sub-lobar resection was permitted. SABR was delivered as per the UK SABR guidelines.
An average recruitment rate of 3 patients/month from the 5 centres over a formal monitoring period was set to prove feasibility of a larger RCT. Meetings with the trial sites and patient representatives were held through-out to improve recruitment. Qualitative research was embedded into the study with interviews for patients who declined participation or randomised treatment.
4c3880bb027f159e801041b1021e88e8 Result
Between July 2015-January 2017 318 patients were assessed for eligibility of which 106 were initially considered eligible. 84 patients were approached for the study and 24 (29%) were randomised (10 surgery, 14 SABR); a mean recruitment rate of 1.7 per month. The median age was 75 (range 54-88). The main reason for declining the study was patient preference with 29% preferring surgery and 42% SABR. Overall 9/24 (38%) did not receive their randomised treatment. Of 7 patients randomised to surgery, 6 received SABR, 1 radical radiotherapy and of 2 patients randomised to SABR, 1 received radical radiotherapy, 1 was lost to follow-up.
8eea62084ca7e541d918e823422bd82e Conclusion
Despite recruiting at higher rate/centre than previous SABR versus surgery trials, the SABRTooth study failed to meet its recruitment target and the majority of patients randomised to surgery subsequently underwent SABR. Therefore, conducting a large RCT in the UK was shown not to be feasible. However, establishing which patients should have surgery or SABR for early stage NSCLC remains a critical question and alternative study designs are being developed to provide an answer for patients and clinicians.
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P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.16-08 - Baseline Quality of Life is Influenced by the Duration of Abstinence from Smoking in Candidates to Lung Cancer Surgery (ID 12350)
12:00 - 13:30 | Author(s): Matthew Eric Callister
- Abstract
Background
The optimal interval of smoking cessation before Non-Small Cell Lung Cancer (NSCLC) surgery is still unknown. The objective of this study is to evaluate the influence of smoking cessation on the preoperative quality of life (QoL) of surgical NSCLC patients.
a9ded1e5ce5d75814730bb4caaf49419 Method
266 consecutive ever smokers (133 females) with a pack year history >=20 undergoing lung resections for NSCLC and with complete preoperative QoL data were analysed. The EORTC QoL summary score was calculated (SumS) as the average of the individual functional and reversed symptom scales (excluding Global-Health and Financial-Impact scales). The following smoking-related variables were tested for a possible association with SumS: age when the patient quit smoking and months elapsed from smoking cessation (for current smokers a value of 0 was used). These variables were entered as independent predictors in a stepwise multivariable regression analysis along with several patient-related baseline factors.
4c3880bb027f159e801041b1021e88e8 Result
108 patients were current smokers, 158 were ex smokers (quit at least 1month before surgery). We found no difference of preoperative QoL SumS between current smokers and ex smokers (81.5 vs. 83.0, p=0.66). Amongst the 158 ex-smokers, 69 quit smoking before the age of 60. Their SumS was similar to the one of those who quit older (84.2 vs. 82.0, p=0.30). A linear regression showed a significant association between the duration of abstinence from smoke and their QoL SumS (coefficient 0.02, SE 0.009, p=0.03). When the analysis was adjusted for other confounders using a multivariable regression analysis, the duration of abstinence from smoking (p<0.0001-longer time better QoL)(Fig1) and the age at which the patient quit smoking (p=0.001-older age better QoL)remained independently associated with SumS along with performance score.
Figure 1: Lowess Curve plotting SumS against the months elapsed from the time quit smoking.
8eea62084ca7e541d918e823422bd82e Conclusion
Patients should be counselled to stop smoking prior surgery independently as the QoL has expected to increase.
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S01 - IASLC CT Screening Symposium: Forefront Advances in Lung Cancer Screening (Ticketed Session) (ID 853)
- Event: WCLC 2018
- Type: Symposium
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/23/2018, 07:00 - 12:00, Room 203 BD
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S01.17 - Session V: Panel Discussion: Next Steps for Lung Screening? (ID 11898)
10:30 - 11:30 | Presenting Author(s): Matthew Eric Callister
- Abstract
- Presentation
Abstract not provided
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
