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Yuanyuan Ma
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P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.16-23 - Long-Term Survival Analysis of Surgery in Potential Stereotactic Ablative Radiotherapy Candidates of Non-Small Cell Lung Cancer (ID 14436)
16:45 - 18:00 | Author(s): Yuanyuan Ma
- Abstract
Background
The aims of this study were to evaluate the long-term survival outcomes and strengthen the primacy of surgery in potential stereotactic body radiotherapy candidates.
a9ded1e5ce5d75814730bb4caaf49419 Method
A total of 541 patients with clinical stage I peripheral non-small cell lung cancer from January 2005 to December 2014 were enrolled in the current study. All patients who were potential stereotactic ablative radiotherapy candidates underwent lobectomy and systematic lymph node dissection including level 13 and 14 without preoperative therapy. According to the recommendation of the 8th edition of TNM stage, combined with our own experience, we divided the N stage into N1a (only level 13-14 positive), N1b (level 10-12 positive), N2a1 (skip single N2), N2a2 (single N2 with N1) and N2b (multiple N2). Survival curves were estimated by the Kaplan–Meier method.
4c3880bb027f159e801041b1021e88e8 Result
Among all patients, 25.0% had occult lymph node involvement, 12.8% were N1 and 12.2% were N2. Among 32 T1a patients only 1 case (3.0%) patients had N1a positive without other N positive. In 104 cases of T1b, the positive rates of N1a, N1b, N2a1, N2a2 and N2b were 0.8%, 5.9%, 0.8%, 2.5% and 1.7%, respectively. Among the 86 patients with T1c, the positive rate of each station was 5.4%, 11.5%, 3.8%, 8.5%, and 4.6%, respectively. Of the 184 patients with T2a, N1 accounted for 14.6% , and N2 accounted for 11.5%. The 3-year, 5-year and 10-year disease free survival (DFS) of all 541 clinical stage I patients were 82.8%, 74.0%, 64.7%, and the overall survival (OS) were 91.3%, 85.4% and 77.0% respectively. The 3-year, 5-year and 10-year DFS of postoperatively pathological stage I patients were 90.0%, 81.0%, 72.5%, and the OS were 94.4%, 91.1% and 85.0%, respectively.
8eea62084ca7e541d918e823422bd82e ConclusionT ／N category
N0
N1a
N1b
N2a1
N2a2
N2b
1a
32(97.0%)
1（3.0%）
0
0
0
0
1b
104(88.1%)
1（0.8%）
7（5.9%）
1（0.8%）
3（2.5%）
2（1.7%）
1c
86(66.2%)
7（5.4%）
15（11.5%）
5（3.8%）
11（8.5%）
6（4.6%）
2a
184(70.8%)
13（5.0%）
25（9.6%）
8（3.1%）
12（4.6%）
18（6.9%）
In view of the high rate of lymph node metastasis in clinical stage I lung cancer, surgical resection is still the preferred treatment.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)
- 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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P2.01-67 - The Prognostic Analysis of Lung Cancer Patients with Occult Malignant Pleural Disease at Thoracotomy (ID 13270)
16:45 - 18:00 | Author(s): Yuanyuan Ma
- Abstract
Background
This study aims to determine the clinicopathological prognostic factors for occult malignant pleural disease (MPD) first detected at thoracotomy in patients with non-small cell lung cancer (NSCLC) and assess the outcome of surgical intervention.
a9ded1e5ce5d75814730bb4caaf49419 Method
A total of 120 patients with MPD at thoracotomy from January 2006 to October 2016 were evaluated. Survival curves were estimated by the Kaplan–Meier method, and Cox regression analysis was performed to validate the selected risk factors. Clinical and pathologic parameters were balanced by propensity score matching when assessing surgical intervention.
4c3880bb027f159e801041b1021e88e8 Result
With a median follow-up of 34 months, the 5-year overall survival of 120 patients was 28.0%. Multivariate analyses showed male (p=0.044), advanced T stages (p<0.001), advanced N stages (p=0.02), pleural invasion in image (p=0.005), pleural effusion (p=0.027), surgical intervention (p=0.008) and EGFR status (p=0.003) were independent predictors of survival. The 5-year survival rate and median survival time (MST) for 21 patients with lobectomy were 71.6% and undefined, compared with 25.6% and 40.0 months in 46 patients with sublobectomy. When 53 patients only subjected to open-close surgery, their 5-year survival rate and MST were 23.4% and 30.2 months. After propensity score matching, both 21 patients were included in lobectomy group and sublobectomy /open-close group. The overall survival of lobectomy group was better than the control group (p=0.046).
8eea62084ca7e541d918e823422bd82e Conclusion
The prognosis of MPD patients first detected at thoracotomy was affected by gender, stage, pleural invasion, pleural effusion, surgical intervention and EGFR status. Lobectomy maybe confers better survival compared with sublobectomy and exploratory thoracotomy.
6f8b794f3246b0c1e1780bb4d4d5dc53
