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Jong Ho Cho



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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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      P1.16-14 - Impact of Smoking on Treatment Outcome in Early Squamous Cell Lung Cancer (T1N0) (ID 13823)

      16:45 - 18:00  |  Author(s): Jong Ho Cho

      • Abstract

      Background

      Smoking is the major risk factor for squamous cell lung cancer. However, squamous cell lung cancer in never-smoker is known to have poor survival outcomes. We compared clinicopathologic features and outcomes between smokers and never-smokers in resected early squamous cell lung cancer (T1N0).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      An institutional database was reviewed retrospectively between 1994 and 2016 (N = 445). Eligible patients included completely resected squamous cell lung cancer, less than 3 cm in tumor size, and without N1 or N2 involvements. Patients were stratified by gender and smoking status.

      4c3880bb027f159e801041b1021e88e8 Result

      423 (95%) smokers and 20 (5%) never-smokers were identified. The median age of never-smokers was 66 years (range, 39 - 83), and 11 of these patients were female (55%). The median age of smokers was 66 (range, 42 - 84), and most of them were male (97.9%). The T stage were distributed equally in both groups. In smokers, 84 (19.9%) patients experienced recurrence whereas only 1 patient (5%) of never-smokers occurred distant metastasis (p < 0.001). Distant metastasis was most frequent recurrence pattern in smokers (n= 40), but locoregional recurrence also a fairly frequent pattern (n = 30). The 5-year overall survival rates and recurrence free survival rates were 70.9% and 61.5% in smokers and were 64.1% and 64.1% in never-smokers respectively (p = 0.65, and 0.34, respectively).

      8eea62084ca7e541d918e823422bd82e Conclusion

      There was no significant differences in clinicopathologic features and outcomes between smokers and never-smokers in early squamous cell lung cancer.

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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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      P3.01-81 - Long-Term Outcome of Surgically Resected Unsuspected N2 Lung Adenocarcinoma (ID 14381)

      12:00 - 13:30  |  Author(s): Jong Ho Cho

      • Abstract
      • Slides

      Background

      This study was performed to assess the long-term outcome of lung adenocarcinoma in patients without clinical suspicion of mediastinal lymph node involvement and whose tumors were finally proven to be pathologic N2.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This is a retrospective study of a prospective lung cancer database at our institution from January 2004 to December 2014. We retrospectively reviewed the medical records of 299 patients with unsuspected pathologic N2 disease.

      4c3880bb027f159e801041b1021e88e8 Result

      The median follow-up time was 51.5 months (range, 1.1 to 172.3 months). The median recurrence-free survival (RFS) was 25.3 months and the 1-year, 3-year, and 5-year RFS rates were 78.2%, 41.0%, and 29.5%. The median overall survival (OS) was 75.2 months and the 1-year, 3-year, and 5-year OS rates were 92.6%, 85.9%, and 62.7%, respectively. The most common type of resection was lobectomy (88.6%). Adjuvant therapy was administered in 255 patients (85.3%). N2 involvement was single station without N1 involvement (“skip” metastasis, N2a1) in 73 (24.4%), single station with N1 involvement (N2a2) in 148 (49.5%), and N2 at multiple stations (N2b) in 78 (26.1%). The median RFS and 5-year RFS rate of N2a1 were 42.9 months and 44.8%. The median and 5-year OS and OS rate of N2a1 were 86.2 months and 69.0%. In multivariate analysis, N2a1, low T-stage, and adjuvant therapy were significantly associated with a longer RFS, whereas pneumonectomy was significantly associated with a worse RFS.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The long-term outcome of unsuspected pN2 group of patients with lung adenocarcinoma was better than expected. Especially the RFS and OS of pN2a1 group of patients were similar to the those of N1 group of patients reported for survival in our group. Therefore, resection of properly staged unsuspected pathologic N2 lung adenocarcinoma is reasonable and should not be avoided if a complete resection without pneumonectomy can be done.

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    P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

    • 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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      P3.16-41 - Postoperative Pembrolizumab for the Patients with Pathologic Stage I Adenocarcinoma with Solid or Micropapillary Pattern (ID 14418)

      12:00 - 13:30  |  Author(s): Jong Ho Cho

      • Abstract

      Background

      Prognosis of surgically resected stage I adenocarcinoma was relatively fair with up to 75% of 5 year disease free survival rate. However, in some cases, in spite of the very small-sized tumor, recurrence as systemic metastasis is found. Solid or micropapillary subtype adenocarcinoma are reported as poor prognostic subtypes, additional treatment after surgical resection for those subgroup was required to improve survival. We reported that incidence of PD-L1 strong positivity is significantly higher in solid-predominant subtype of adenocarcinoma, PD-L1 inhibitor can be more effective adjuvant treatment modality in those subtype.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Design: Open-label, single arm, single center, phase 2 trial. (NCT03254004)

      Eligibility: The subject must have primary lung adenocarcinoma with stage I and less than 4 centimeter, whose tumor should be solid-predominant or micropapillary (>5%) by postsurgical pathological examination.

      Objective: The primary objective of this study is to assess the improvement of disease-free survival rate by adjuvant therapy with pembrolizumab for solid or micropapillary adenocarcinoma with pathologic stage I and tumor size less than 4 cm. The secondary objective is to assess the safety profile of adjuvant pembrolizumab in adjuvant setting.

      Treatment: Pembrolizumab 20mg IV infusion every 3 weeks for 12 months until disease progression or prohibitive toxicity. The treatment should be started within 8 weeks after surgery.

      Statistics: The hypothesis is that adjuvant pembrolizumab will improve 3-year disease-free survival from 65% to 80% in pathologic stage Ia lung adenocarcinoma patients with solid/micropapillary subtypes. Assuming that the subject enrollment period is 1.5 years, follow-up of last registered subject period is 4 years, and the disease free survival period follows the exponential distribution, a significance level 5% (one side) and 63 peoples are required 85% at the power of test. At this time, assuming that the dropout rate is 10%, it is necessary to register 70 subjects

      Assessment : Chest CT (covering up to both adrenals) will be done every 3 months till 1 year since the study treatment, and then every 4 months afterward till 2 years and thereafter every 6 months till 3 years. Brain MRI and bone scan will be done at 1 year and 2 years since the study treatment. This study is an investigator-initiated trial with support from MSD.

      4c3880bb027f159e801041b1021e88e8 Result

      Section not applicable

      8eea62084ca7e541d918e823422bd82e Conclusion

      Section not applicable

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