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Saul Campos-Gomez
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P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)
- 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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P1.15-04 - Practice Patterns Regarding Multidisciplinary Cancer Management for NSCLC and implemetantion: Results of National Survey in México (ID 14374)
16:45 - 18:00 | Presenting Author(s): Saul Campos-Gomez
- Abstract
Background
To manage patients with advanced lung cancer in the most effective way, experts from different disciplines need to be engaged. This has resulted in introduction of the multidisciplinary team (MDT) approach. Because of these advantages, current clinical guidelines recommend discussing the diagnostic and therapeutic plan with an MDT for localized or locally advanced Non-Small Cell Lung Cancer (NSCLC). However, studies suggest despite the advantages of multidisciplinary care, the proportion of new lung cancer diagnoses that are formally discussed in Lung Cancer MDM are disappointing low, in the order of 28–29%. An Australian survey suggests that only one third of hospitals have a multidisciplinary team.
a9ded1e5ce5d75814730bb4caaf49419 Method
However, it is unclear how specialists view current evidence about multidisciplinary team (MDT) approach and how they would incorporate into practice. We sought to understand specialist opinions about evidence regarding treatment of NSCLC and how this translates into clinical practice implementation.This study was conducted to explore specialist opinions about multidisciplinary team approach of NSCLC, how this translates into practice and the implementation in Mexico.
4c3880bb027f159e801041b1021e88e8 Result
We collected a total of 60 completed responses (50%), 77% were medical oncologist, 7% surgical oncologist and 17% radiation oncologists. Of these 34% mainly worked in private and 66% in public healthcare Systems. Seventy two percent of all physicians were < 40 years, 25% between 40 and 50 years of age and 22% were 50 years of age or older. Young doctors (up to 5 years of service) accounted for 45 %, with a median length of practice of 12 years. More than two-thirds of physicians were male. Approximately 58% of respondents stated that exist a MDTs for NSLC in their institutions. The Core members of the multidisciplinary cancer team usually include an oncologist (medical, surgical, radiation), pathologist and radiologist in the 65% of the teams. Approximately 55% of respondents stated that MDTs met regularly. Forty two of survey responders do not have a MDT but can discusses new cases directly with surgical oncologist o radiologist.
8eea62084ca7e541d918e823422bd82e Conclusion
While multidisciplinary care has emerged as the standard of care for lung cancer management. The challenge for the future is how to more fully integrate multidisciplinary care into the management of all patients with lung cancer in México.
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P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)
- 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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P3.01-10 - Dyspnea as a Prognostic Factor in Hispanic Patients with Non-Small Cell Lung Cancer Cohort (ID 13072)
12:00 - 13:30 | Presenting Author(s): Saul Campos-Gomez
- Abstract
Background
Lung cancer is a commonly diagnosed cancer, and the leading cause of cancer death around the world. Over 80% of lung cancer patients in México are diagnosed in advanced stage. Common symptoms include cough, dyspnea, weight loss, and chest pain. Dyspnea is one of the most common symptoms in patients with lung cancer at initial presentation with a prevalence of 55–90%. The intensity of dyspnea is an important and validated factor for assessment of quality of life (QOL) in cancer patients. In addition, improvement of health-related QOL and symptoms, such as dyspnea, are related with the efficacy of chemotherapeutic regimens and favorable outcome in lung cancer. In this study, we investigated the association between the degree of dyspnea and clinical outcomes to identify the prognostic role of dyspnea in hispanic patients with non-small cell lung cancer (NSCLC).
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively reviewed lung cancer database of Centro Oncologico Estatal ISSEMYM. From 2013 to 2016 we enrolled patients with diagnosis of advanced NSCLC. Clinicopathological information on age, sex, smoking history, histologic type, stage, Eastern Cooperative Oncology Group (ECOG) performance status, clinical outcomes and evaluation of symptoms of dyspnea at diagnosis using modified Medical Research Council (mMRC) scores from each patient were recorded.
4c3880bb027f159e801041b1021e88e8 Result
A total of 120 patients with diagnosis of NSCLC were identified, of these only in 65 patients (54%) the symptom of dyspnea were detected and evaluate using modified Medical Research Council (mMRC) scores at initial diagnosis. The median age was 58 years. Among those patient with dyspnea and mMRC scores available at diagnosis, 29 (45%) patients had an mMRC score ≥ 2, while 36 (55 %) had an mMRC score < 2. In multivariate analysis, poor performance status and an mMRC score ≥2 were found to be significant prognostic factors for patient survival. The overall median survival for all patients was 18 months. The overall survival of patients with dyspnea (mMRC grade 2 or higher) was significantly lower than that for patients without or low grade dyspnea (median survival, 17 months vs. 35 months, p<0.036).
8eea62084ca7e541d918e823422bd82e Conclusion
In conclusion, this study showed that the dyspnea mMRC mMRC grade 2 or higher in Hispanic patient with NSCLC were significantly associated with poor prognosis. Therefore, clinicians should pay more attention to evaluation and management of dyspnea.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.11 - Screening and Early Detection (Not CME Accredited Session) (ID 977)
- 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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P3.11-14 - Low Rates of Lung Cancer Screening Among Doctors in Mexico (ID 14203)
12:00 - 13:30 | Author(s): Saul Campos-Gomez
- Abstract
Background
Lung cancer represents the leading cause of death from cancer worldwide and in Mexico. Most patients are diagnosed in advanced stages at the time of diagnosis and treatment in these cases is palliative. Lung cancer screening with low-radiation exposure tomography has shown to reduce mortality due to early detection of the disease in high-risk individuals. In Mexico more than 80% of patients are diagnosed in the metastatic stage. Our objective is to know the frequency of screening for lung cancer among neumologists, thoracic surgeons and oncologists in Mexico and the reasons why they do not.
a9ded1e5ce5d75814730bb4caaf49419 Method
Transversal, descriptive study, carried-out during the international congress of pneumology and thoracic surgery from April 2-6, 2018, in Guanajuato, Mexico. A survey was conducted in Mexican doctors from different specialties and different public and private institutions, they were questioned if they consider screening for lung cancer useful, if they do it, if the screening can be applied to Mexico and what are the barriers that it finds not to do it. The data were emptied into a database in the SPSS v23 system and descriptive statistics were made for the analysis.
4c3880bb027f159e801041b1021e88e8 Result
A total of 147 specialist doctors were interviewed, 49% were oncologists, 43% were neumologists and 8% were chest surgeons. Despite the fact that 86% considered screening to be useful, only 36% performed it within their daily clinical practice. The main barriers they found to implement screening in our country were due to multiple factors according with response of 70% of physicians where lack of CT scan and qualified personnel to interpret image results were the most prevalent. The remaining 30% considered only one factor as the most important where the lack of infrastructure (CT scan) was the most prevalent in 14% of the answers.
8eea62084ca7e541d918e823422bd82e Conclusion
Although the specialists in prevention, diagnosis and treatment of lung cancer in Mexico are aware of the usefulness of screening for lung cancer, the frequency of implementation is low, mainly due to lack of appropriate infrastructure and trained personnel. It is necessary to implement public health policies to promote screening in the majority of patients who meet the high-risk criteria to increase early diagnosis and subsequently improve survival outcomes in this population.
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