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Lv Huang



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    MA22 - New Therapeutics, Pathology, and Brain Metastases for Small Cell and Neuroendocrine Tumour (ID 925)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 15:15 - 16:45, Room 206 BD
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      MA22.07 - Prognostic Value of Distant Organ-Specific Metastases in Newly Diagnosed Lung Neuroendocrine Tumors: A Population-Based Study (ID 12684)

      15:55 - 16:00  |  Author(s): Lv Huang

      • Abstract
      • Presentation
      • Slides

      Background

      Lung neuroendocrine tumors (Lung NETs) are rare neoplasms with inferior outcomes for patients with distant metastases. AJCC cancer staging system for the classification of NETs was first introduced in 2010. However, the prognostic impact of metastatic sites for lung NETs are poorly explored. We aimed to fill this gap of our knowledge using the SEER database.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Clinical-pathological characteristics, specific metastatic sites and outcomes of stage IV lung NETs (according to AJCC 7th edition) were extracted from the SEER database from 2010-2014. Overall survival (OS) and Lung cancer-specific survival (LCSS) were estimated by the Kaplan-Meier method and comparisons conducted using log-rank tests and Cox regression models.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 2337 stage IV lung NETs patients were identified. The 5-year OS and LCSS were 10.7% and 18.3%, respectively. Among them, 2159 patients had specific organ metastases (liver, lung, bone or brain) at diagnosis. Liver was the most common metastatic site (1183, 50.6%), followed by bone (801,34.3%), lung (701,29.9%) and brain (616,26.4%). Patients with isolated lung metastases (1-, 5-year OS: 63.2%, 43.2%; 1-, 5-year LCSS: 74.0%, 62.9%,) had significantly better outcomes comparing to other patterns of metastases. The outcomes of patients with any brain metastases was most unfavorable (1-, 5-year OS: 20.3%, 2.1%, p<0.001; 1-, 5-year LCSS: 26.8%, 7.7%, p<0.001). Multivariate Cox regression analysis on OS and LCSS revealed that age > 60 years (p<0.001), male gender (p<0.001), poorer differentiation (p<0.001) and brain metastases (p<0.001) were independently poor prognostic factors for stage IV lung NETs patients.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The prognostic impact of metastatic site was unambiguous in stage IV patients with lung NETs. Comparing other metastatic patterns, brain metastases was associated with significant worse survival outcomes. Nearly twenty-fold difference in 5-year survival was revealed between isolated lung and brain metastases. For advanced lung NETs patients, brain metastases might be considered as a distinct category of dismal outcomes.

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