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Oliver Kayden Jawitz

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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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      P1.16-50 - The Role of Adjuvant Therapy for Patients with Early Stage Large Cell Neuroendocrine Lung Cancer: A National Analysis (ID 13077)

      16:45 - 18:00  |  Author(s): Oliver Kayden Jawitz

      • Abstract
      • Slides


      Although large cell neuroendocrine lung cancer (LCNEC) generally has a worse prognosis than other non-small cell lung cancer histologies, data regarding the role of adjuvant therapy in completely resected stage I LCNEC are extremely limited and current guidelines do not routinely recommend adjuvant therapy. This U.S. National Cancer Data Base (NCDB) analysis was performed to improve the evidence guiding decision-making regarding postoperative therapy for early stage LCNEC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Overall survival of patients with pathologic T1-2aN0 LCNEC who underwent resection in the NCDB from 2003 to 2015 was evaluated using Kaplan-Meier and multivariable Cox proportional hazard analysis. Patients who died within 30 days of surgery were excluded. These prospective data were acquired by certified tumor registrars, and include over 80% of cancer diagnoses annually in the U.S.

      4c3880bb027f159e801041b1021e88e8 Result

      Of the 5,177 patients who met study criteria, adjuvant therapy was given to 31% of patients (n=1585): 20% received chemotherapy (n=1039), 8% chemoradiation (n=400), and 3% radiation (n=146). In stage IA LCNEC, adjuvant chemotherapy was associated with improved survival when compared to no adjuvant therapy in unadjusted analysis (five-year survival 55% vs. 53%; p=0.03) but not after multivariable adjustment (hazard ratio [HR] 0.81; 95% CI 0.64 to 1.02). Of note, adjuvant chemoradiation (HR 1.66; 95% CI 1.11 to 2.48) and adjuvant radiation (HR 1.55; 95% CI 1.06 to 2.25) were associated with worse survival when compared to no adjuvant therapy. In stage IB LCNEC, adjuvant chemotherapy was associated with improved survival when compared with no adjuvant therapy in both univariate (five-year survival 60% vs. 43%; p<0.0001; Figure) and multivariable (HR 0.65; 95% CI 0.48 to 0.88) analyses.

      final wlc lcnec figure 05.04.18.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      In this NCDB study of resected stage I LCNEC, adjuvant chemotherapy was associated with improved survival after resection of stage IB but not stage IA LCNEC.


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