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Jiaxi He
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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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P1.16-35 - Sleeve Lobectomy Versus Pneumonectomy for Non-Small Cell Lung Cancer, a Cumulative Updated Meta-Analysis (ID 13668)
16:45 - 18:00 | Author(s): Jiaxi He
- Abstract
Background
Sleeve lobectomy (SL) is an appealing alternative to pneumonectomy (PN) for central or locally advanced non-small cell lung cancer (NSCLC). The purpose of this study was to investigate the benefits of SL versus PN for NSCLC through cumulative meta-analysis.
a9ded1e5ce5d75814730bb4caaf49419 Method
A systematic review and cumulative analysis of comparative studies reporting both postoperative and survival outcomes of SL and PN was performed through a comprehensive search of PubMed, EMBASE and the Cochrane library electronic databases from inception to April 2018
4c3880bb027f159e801041b1021e88e8 Result
A total of 9153 patients (SL: 3658, PN: 5495) from thirty-two studies were included. Meta-analysis was conducted for hazard ratio (HR), postoperative mortality, postoperative morbidity, local recurrence, and overall survival. PN was inferior to SL in terms of hazard ratio (HR=0.66, 95% confidence interval [CI]=0.59 to 0.75, I2=56%). Lower postoperative mortality was found in SL group (OR=0.45, 95% CI=0.36 to 0.56, I2=0.0%). While SL and PN showed no significant difference in local recurrence (OR=0.86, 95% [CI]=0.69 to 1.07, I2=45.0%) or postoperative morbidity (OR=0.92, 95% [CI]=0.78 to 1.09, I2=29.0%). Moreover, the 1-, and 5-years survival rates (1-yr: OR=2.19, 95% CI=1.93 to 2.5, I2=14.0%) (5-yrs: OR=1.94, 95% CI=1.61 to 2.35, I2=52.0%) and survival in patients with pN0 or pN1 at 5-years (OR=1.79, 95% CI=1.19 to 2.67, I2=3.0%) in the SL group were significantly higher than that in the PN group. As demonstrated in our cumulative meta-analysis, these effects were consistent over the years.
8eea62084ca7e541d918e823422bd82e Conclusion
SL could be considered an acceptable alternative to PN for the treatment of NSCLC.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P2.06 - Mesothelioma (Not CME Accredited Session) (ID 955)
- 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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P2.06-14 - Does Size Matter? A Population-Based Analysis of Malignant Pleural Mesothelioma (ID 11750)
16:45 - 18:00 | Presenting Author(s): Jiaxi He
- Abstract
Background
The malignant pleural mesothelioma (MPM) is a rare and aggressive malignancies. A validated staging system is crucial for disease evaluation, treatment selection and follow-up strategy. The 8th edition staging system for MPM has been recently proposed. However, it has not been widely accepted due to the absence of validation of large cohort. Besides, the size of tumor is not taken into consideration. We intend to elucidate the prognostic value of the size of MPM and evaluate the current staging system via the data of SEER database.
a9ded1e5ce5d75814730bb4caaf49419 Method
All cases of primary MPM were identified and extracted from the SEER database during the period of 1973-2013. Kaplan-Meier method was used to analyzed overall survival and cancer-specific survival. The prognostic factors were identified by Cox regression. LOWESS smoothing regression curve was also utilized. The cut-off points of size in different strata were identified based on the graphical characteristics. The tumor stage was established incorporating tumor extension and size. The adjusted clinical staging system was proposed and compared with the previous MPM staging system by likelihood ratio test.
4c3880bb027f159e801041b1021e88e8 Result
A total of 2138 patients were included. The 1,3 and 5-year survival rates of MPM were 39.4%, 11.8% and 3.8%. Tumor extension, lymph node involvement and metastasis, tumor size, histology and differentiatial grade were significant prognostic factors. Radical surgery and local destruction might have the similar effect in early stage patients. Triple combination treatments showed a superiority to others. The cut-off points of tumor size were ≤3cm and >7cm. The adjusted staging system was proved to be more accurate.
8eea62084ca7e541d918e823422bd82e Conclusion
Tumor size matters in the prognosis of MPM especially in early stages. The adjusted TNM staging system incorporating tumor size has better accuracy than the 8th edition. However, some stages had not been fully verified. More cases of early stages are warranted for essential revision.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P2.17 - Treatment of Locoregional Disease - NSCLC (Not CME Accredited Session) (ID 966)
- 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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P2.17-33 - Role of Adjuvant Therapy in Pulmonary Adenosquamous Carcinoma (ID 12434)
16:45 - 18:00 | Presenting Author(s): Jiaxi He
- Abstract
Background
Lacking of the data on the pulmonary adenosquamous carcinoma causes difficulty in choosing therapies. No study reported the role of adjuvant therapy in stage I of this type. This study was performed to elucidate the necessity and effect of adjuvant therapy in patients who received complete resection for Stage I adenosqumaous lung cancer.
a9ded1e5ce5d75814730bb4caaf49419 Method
Patients with T1-2N0M0 adenosqumaous lung cancer who underwent complete resection in the SEER database from 2004 to 2014 were identified. The overall survival were evaluated using Kaplan-Meier and Cox regression. Patients with pre-operative treatments were excluded.
4c3880bb027f159e801041b1021e88e8 Result
A total of 1152 patients with T1-2N0M0 adenosquamous lung cancer were included. Among them, 607 and 545 patients were diagnosed as IA/IB. 929 patients received surgeries alone whose 1, 5, 10-year survival rate were 92.4%, 73% and 56.8%, while 223 patients received adjuvant chemotherapy whose survival rate were 82.1%, 49.6% and 41.3%, respectively. Patients in IA without adjuvant therapy had better outcomes. No survival benefit was observed in IB. Tumor size, age, sex and grade were significant prognostic factors.
8eea62084ca7e541d918e823422bd82e Conclusion
Adjuvant therapy may not be recommended to the patients with pulmonary adenosquamous carcinoma in stage IA-IB. More cases and clinical data are warranted to verify such findings and elucidate the roles of adjuvant therapy.
6f8b794f3246b0c1e1780bb4d4d5dc53
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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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P3.16-24 - Prognostic Value of Positive Lymph Node Ratio in Non-Small Cell Lung Cancer (ID 13984)
12:00 - 13:30 | Presenting Author(s): Jiaxi He
- Abstract
Background
Previous studies had shown the importance of lymph node (LN) resection in T1 NSCLC and recommended no less than 16 LN examination. Few of them reported the role of positive lymph node ratio (PLR). This study was performed to elucidate the prognostic value of PLR in T1 LN positive NSCLC.
a9ded1e5ce5d75814730bb4caaf49419 Method
Patients with T1N1-2M0 NSCLC who underwent complete tumor and LN resection in the SEER database from 2009 to 2014 were identified. PLR was defined as positive LN/examined LN. The cut-off value wad determined by ROC. The overall survival of patients was evaluated using Kaplan-Meier and Cox regression analysis. Those whose LN examination number was less than 16 were excluded.
4c3880bb027f159e801041b1021e88e8 Result
A total of 362 cases were included in the primary cohort. Among them, female accounted for 51.7%. The median number of examined and positive LN were 21 and 2, respectively. Patients with lower PLR had better OS in N2 but no significant result was observed in N1.
8eea62084ca7e541d918e823422bd82e Conclusion
PLR has significant prognostic value in N2 group. Greater PLR predicts worse prognosis. More cases and clinical data are warranted to verify the effect of PLR in the contemporary staging system.
6f8b794f3246b0c1e1780bb4d4d5dc53
