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Michael F Reed

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    MA23 - Early Stage Lung Cancer: Present and Future (ID 926)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 10:30 - 12:00, Room 105
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      MA23.05 - Post-Operative Radiation Improves Overall Survival in Patients with Node-Positive Non-Small Cell Lung Cancer Undergoing Sublobar Resections (ID 14350)

      11:00 - 11:05  |  Author(s): Michael F Reed

      • Abstract
      • Presentation
      • Slides


      The incidence and prognosis associated with patients undergoing sub-lobar resections and having positive lymph nodes(PLN) has been rarely studied. Our investigation will retrospectively review this topic.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The National Cancer Database(NCDB) was queried during the years 2004-2014 to assess patients undergoing sub-lobar resection (wedge, segmentectomy, and sub-lobar-NOS, N = 38,599) and specifically the patients with PLN (N = 5484). Patients were excluded who had any pre-op chemotherapy and/or radiation, had follow-up of less than 3 months, had stage IV disease or >1 tumor nodule. Multi-variable modeling(MVA) was used to determine factors for overall survival (OS). Propensity score matching(PSM) was used to determine pre-operative risk factors for PLN in patients having at least one node examined(N=22712) (matched by median number of nodes examined) and to assess the role of radiation in those patients with node positive disease (matched by age, sex, stage, chemotherapy, and number of nodes positive).

      4c3880bb027f159e801041b1021e88e8 Result

      The incidence of PLN decreased progressively during our study from 17.9% in 2004 to 9.4% in 2014 (N1 8.3-5.0% and N2 9.6-4.4%). A lower risk of PLN was noted for squamous cell carcinomas, bronchoalveolar (minimally invasive) adenocarcinomas, and right upper lobe locations; but the risk increased with age, tumor size and clinical stage. In the node positive group, MVA demonstrated that OS was worse with males, older ages, non-Hispanic Whites (compared to Asian and Hispanic Whites), lowest income quartile, Charlson co-morbidity > 0, grade, tumor size, number of positive nodes, positive surgical margins, length of stay, and not receiving chemotherapy or radiation. PSM demonstrated that radiation increased OS in patients having PLN regardless of margin status or N level involvement.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The incidence of node positive sub-lobar resections has decreased during the years of our study, but still can be found in nearly 10%. In both MVA and PSM, post-operative radiation improves OS.


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