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Zhichao Liu
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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: 2
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.16-41 - The Role of Surgery in Pulmonary Large Cell Neuroendocrine Carcinoma: A Propensity-Score Matching Analysis of SEER Database (ID 12772)
16:45 - 18:00 | Presenting Author(s): Zhichao Liu
- Abstract
Background
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive subset of non-small-cell lung cancer with poor prognosis. Due to its rarity, the optimal therapy strategy for pulmonary LCNEC remains undefined. We aimed to evaluate the role of surgery for stage I-III LCNEC using the Surveillance, Epidemiology, and End Results (SEER) database.
a9ded1e5ce5d75814730bb4caaf49419 Method
Patients with stage I-III LCNEC were extracted from the SEER database (2004-2014). Propensity-score matching was performed to reduce the effect of potential confounders. Kaplan-Meier curves were constructed for overall survival (OS) and cancer-specific survival (CSS) for patient strata based on surgery use or nonuse. Multivariable Cox-regression was used to explore the efficacy of different treatment strategies.
4c3880bb027f159e801041b1021e88e8 Result
A total of 944 LCNEC patients were identified, of which 674 (71.4%) received surgery. Both OS and CSS of surgery use group were superior to surgery nonuse group in the whole cohort (HR=0.48, P<0.001 and HR=0.41, P<0.001, respectively). Among matched cohort, significantly greater benefits in OS and CSS (Figure 1) from surgery was observed in both stage I-II (HR=0.47, P=0.001 and HR=0.43 P<0.001, respectively) and stage III (HR=0.66, P=0.039 and HR=0.63, P=0.031, respectively). On multivariable analysis of surgical group, there was no significant difference in either OS or CSS between surgery alone and the addition of chemotherapy or (and) radiation for stage I-II patients, whereas favorable survival outcomes of surgery plus chemotherapy (OS: HR=0.26, P<0.001; CSS: HR=0.30, P=0.001) and surgery plus chemotherapy and radiation (OS: HR=0.33, P<0.001; CSS: HR=0.34, P=0.002) were significantly evident for stage III patients.
8eea62084ca7e541d918e823422bd82e Conclusion
This is the largest study exploring the benefit of surgery for stage I-III pulmonary LCNEC. Regardless of stage, surgery showed remarkable survival benefits for LCNEC patients. It is suggested that surgery alone may be sufficient for stage I-II, whereas the multimodal combination of surgery and other therapies should be considered for stage III disease.
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P1.16-48 - The Impact of Segmentectomy Versus Lobectomy on Pulmonary Function of Patients with Non-Small Cell Lung Cancer: A Meta-Analysis (ID 12839)
16:45 - 18:00 | Author(s): Zhichao Liu
- Abstract
Background
Lobectomy (Lob) and lymph node dissection is considered as the standard surgical procedure for non-small cell lung cancer (NSCLC). Segmentectomy (Seg) has been recently regarded as an alternative in early peripheral NSCLC owing to its advantages of lung function reservation. Thus, we performed a meta-analysis with the aim of evaluating whether Seg offers a better lung functional advantage over Lob.
a9ded1e5ce5d75814730bb4caaf49419 Method
A comprehensive search of online databases was performed. Perioperative outcomes and lung functional index and were synthesized. The odds ratio (OR) or SMD and its 95% CI was calculated using a random effects model. Subgroup was conducted according to different time points. Single-arm meta-analysis was conducted for lung function at each visit time. Repeated-measures analysis of variance (ANOVA) was used to compare the lung function between at each visit.
4c3880bb027f159e801041b1021e88e8 Result
A total of 5 eligible studies including 958 patients were recruited. There were no significant differences according to baseline characteristics before surgery between groups (Seg and Lob). Seg correlated with a greater postoperative preserved pulmonary function than Lob in FVC (SMD=0.23, p=0.009) (Figure A) and FEV1 (SMD=0.27, p=0.002) (Figure B), especially before 12 months. ANOVA showed there were no differences between two groups in FVC (p=0.647) and FEV1 (p=0.468) according to each visit time (Figure C). Seg group showed significantly less postoperative complications compared with the Lob. (OR=0.64, p=0.045) and the recurrence rate were same between groups (OR=0.89, p=0.623).
8eea62084ca7e541d918e823422bd82e Conclusion
Seg offers a better lung functional preservation in short time and reduces postoperative complication compared with Lob. However, two groups showed no significant difference on lung function and tumor relapse according to long follow up.
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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P3.16-46 - The Comparison Between Non-Intubated and Intubated Thoracoscopic Resection for Pulmonary Nodule: A Meta-Analysis (ID 13707)
12:00 - 13:30 | Author(s): Zhichao Liu
- Abstract
Background
General anesthesia with single-lung ventilation is considered mandatory for thoracoscopic anatomical resection for non–small cell lung cancer (NSCLC). Few studies have demonstrated non-intubated thoracoscopic surgery offers several advantages over the procedure with tracheal intubation. Thus, we performed a meta-analysis with the aim of evaluating whether non-intubated thoracoscopic anatomical resection offers better perioperative outcomes over intubated thoracoscopic anatomical resection to pulmonary nodule.
a9ded1e5ce5d75814730bb4caaf49419 Method
A comprehensive search of online databases was performed. Intraoperative and postoperative variables were compared between subgroups. The odds ratio (OR) or SMD and its 95% CI was calculated using a random effects model. Heterogeneity across studies was examined by the Cochran Q chi-square test and the I² statistic.
4c3880bb027f159e801041b1021e88e8 Result
A total of 4 eligible studies including 556 patients were recruited. All included studies had comparable baseline characteristics and surgical procedures. Non-intubated anesthesia thoracoscopic surgery was performed on 250 patients, whereas the other 306 patients underwent intubated surgery. Patients who underwent non-intubated surgery correlated with significant shorter postoperative hospital stays (SMD=-0.36, p<0.001) (Figure A) and postoperative fasting time (SMD=-2.80, p<0.001) (Figure B). Patients underwent non-intubated surgery also exhibited a trend toward lower cardiovascular complication rates (1.45% vs 2.69%, OR=0.59, p=0.551) and respiratory complication rates (8.23% vs 11.18%, OR=0.78, p=0.454), shorter anesthesia duration (SMD=-0.48, p= 0.056) and operative time (SMD=-0.07, p=0.521) with no statistical significance.
8eea62084ca7e541d918e823422bd82e Conclusion
Non-intubated thoracoscopic anatomical resection showed significantly shorter postoperative fasting time and hospital stay compared with intubated thoracoscopic anatomical resection, indicating a more rapid recovery after surgery. Further large scale study should focus on prospective validation of feasibility and safety for non-intubated thoracoscopic approach.
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