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Jang-Ming Lee
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P1.14 - Thymoma/Other Thoracic Malignancies (Not CME Accredited Session) (ID 946)
- 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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P1.14-05 - The Association of Pulmonary Function with Survival After Treatment in Patients with Esophageal Cancer (ID 12098)
16:45 - 18:00 | Author(s): Jang-Ming Lee
- Abstract
Background
Previously studies have found that inadequate pulmonary function of the patients with esophageal cancer can associate with higher risk of postoperative pulmonary complications which can lead to a higher risk of mortality in the perioperative period or long term follow-up. In this study, we investigate the prognostic effect of pulmonary function for the patients of esophageal cancer after treatment.
a9ded1e5ce5d75814730bb4caaf49419 Method
From 2004~2016, 732 esophageal cancer patients underwent surgical treatment were enrolled. They received pulmonary function before treatment, and 542 (74.04%) underwent pre-operative concurrent chemoradiotherapy (CCRT) before surgery. Patients were divided into three groups by pulmonary function level (FEV<80%, inadequate pulmonary function; 80% < FEV1 < 100%, adequate pulmonary function; FEV1 > 100%, well pulmonary function). We use multivariate analysis including all of the possible factors to evaluate overall survival and progression-free survival after surgery.
4c3880bb027f159e801041b1021e88e8 Result
As the result, we found that cancer staging, neo-adjuvant CCRT, operation method and pre-operative FEV1 were found statistically significant for survival after treatment. As compared to patients with FEV1 less than 80% of prediction, patients with EFV1 more than 80% had an around thirty percent of decreasing mortality rate after surgery (p = 0.034). The cox-regression with survival analysis also revealed that patients with better lung function, had significantly better progression-free survival (P<0.05, respectively) than those with poor lung function. Besides, the grouping by CCRT-pCR (pathologic complete response) also had similar results. It maybe due to pulmonary function is a important immunological factor in those esophageal cancer patients.
8eea62084ca7e541d918e823422bd82e Conclusion
Although the patient selection, surgical technique, and other postoperative management have been markedly improved in recent years, the morbidity rate after esophagectomy for esophageal cancer remains high. Recent studies lead us pay attention to the perioperative and postoperative care, but they may ignored the pulmonary function disturbance is one of the major contributing factor for long-term and progression-free survival.
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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P2.01-113 - Prognostic Roles of Neoadjuvant and Adjuvant Chemotherapy for Treating Patients with Operable Stage III-N2 Non-Small Cell Lung Cancer (NSCLC) (ID 13455)
16:45 - 18:00 | Author(s): Jang-Ming Lee
- Abstract
Background
The therapeutic options for stage III-N2 positive NSCLC, including the diseases with ipsilateral mediastinal or subcarinal lymph node involvement, are with multidisciplinary approaches. The NCCN and ASCO guideline recommends the cisplatin-based adjuvant chemotherapy (Ad C/T). Meanwhile, some studies revealed the benefits of managing the N2 node disease with the neoadjuvant chemotherapy (Neo C/T) followed by surgery. We currently analyzed the clinical benefit of Neo C/T and Ad C/T for treating N2 positive NSCLC in a single-center cohort.
a9ded1e5ce5d75814730bb4caaf49419 Method
The study was done retrospectively. A total of 258 patients with N2+ who received surgical resection in dept. of surgery, National Taiwan University Hospital during 2004 to 2016 were enrolled. The mean follow-up duration was 44 months. Both the overall survival (OS) and progression-free survival (PFS) were compared between C/T (-) (patients without chemotherapy treatment) , neo C/T, and Ad C/T groups using multivariate analysis and Kaplan-Meier estimates .
4c3880bb027f159e801041b1021e88e8 Result
There were 77, 55 and 126 patients in C/T (-), Neo C/T, and Ad C/T groups respectively. Patient's characteristics revealed the distributions of age and operation methods among these 3 groups were significantly differences. Patients treated with chemotherapy (combining Neo C/T and Ad C/T groups) were with significant reduced hazard for death compared to C/T (-) group (HR [95 % CI]= 0.55 [0.37-0.83), P=0.004). No significantly difference in overall survival was found between neo C/T and Ad C/T groups (HR [95 % CI]= 0.84 [0.54-1.32), P=0.451). The median overall survival time after surgery for the patients in neo C/T, and Ad C/T, and C/T (-) groups were also significant different (46.2, 56.9, and 26.9 months in C/T (-), Neo C/T, and Ad C/T groups respectively, P<0.001). However, there was no significant difference in patients received C/T or not in progression-free survival.
8eea62084ca7e541d918e823422bd82e Conclusion
Both Ad C/T and Neo C/T provide clinical benefit for the patients with operable stage III N2 NSCLC . These is no significantly difference between Ad C/T and Neo C/T groups in both overall and progression-free survival .
6f8b794f3246b0c1e1780bb4d4d5dc53
