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Samina Park



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    P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

    • 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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      P2.01-47 - Clinical Outcome After Surgical Resection Of Clinical Single-station N2 Non-Small Cell Lung Cancer (ID 13892)

      16:45 - 18:00  |  Author(s): Samina Park

      • Abstract
      • Slides

      Background

      We set up our treatment protocol performing upfront surgery for non-bulky, single-station clinical N2 (cN2a) patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between 2012 and 2016, 129 patients underwent upfront surgery for cN2a disease diagnosed on CT and PET-CT findings. 85 patients underwent preoperative invasive mediastinal staging (IMS group), whereas, in 44, IMS was not performed (Non-IMS group). Survivals were compared with log-rank test. Subgroup analysis for pN2-3 is performed to identify prognostic factors using Cox-regression.

      4c3880bb027f159e801041b1021e88e8 Result

      Pathologic N stages were pN0-1 in 26 patients (20%: 18 IMS, 8 non-IMS), pN2a in 51 (40%: 33 IMS, 18 non-IMS), pN2b in 47 (36%: 29 IMS, 18 non-IMS) and pN3 in 5 (4%: all IMS). The overall 5-year survival was 55.4% with no difference between groups (p=0.19). In pN2-3 patients, 5-year survival was 51.0% and IMS group was better (p=0.05). In a Cox’s regression, non-IMS (HR 1.89, p=0.04), no adjuvant chemotherapy (HR 3.55, p<0.001), extensive burden of metastatic lymph nodes (number of metastatic LN≥13, HR 3.32, p=0.002) were independent risk factors for survival.

      wclc-2018-table.pngwclc-2018-figure.png

      8eea62084ca7e541d918e823422bd82e Conclusion

      We found significant number of cN2a patients were pN2b-3 even after IMS, but surgery resulted in reasonable survival. This suggests upfront surgery for cN2a disease is a valid option if preoperative IMS and adjuvant chemotherapy are warranted.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)

    • 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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      P2.16-28 - Comparison of Outcomes of VATS Segmentectomy Versus Lobectomy for Non-Small Cell Lung Cancer Using a Propensity Score Matching Analysis (ID 13583)

      16:45 - 18:00  |  Author(s): Samina Park

      • Abstract
      • Slides

      Background

      The aim of this study was to compare surgical and oncologic outcomes between thoracoscopic segmentectomy and lobectomy for the patients with non-small cell lung cancer (NSCLC).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between 2009 and 2016, 250 thoracoscopic segmentectomies (Group S) and 1,550 thoracoscopic lobectomies (Group L) were performed in patients with NSCLC in our institute. Indications for segmentectomy were peripherally located tumor with smaller than 2 cm size, or the patients with limited pulmonary reserve and multiple comorbidities. Propensity score matching was conducted using preoperative clinical parameters and 240 patients in each Group S and L were included in the study.

      4c3880bb027f159e801041b1021e88e8 Result

      Most commonly performed segmentectomies were left upper lobar upper division segmentectomy (26.7%) and right lower lobar superior segmentectomy (17.1%). Operation time and length of hospital stay were comparable between the groups (162.9 ± 52.8 min and 5.7 days in group S vs. 163.2 ± 40.1 min and 8.7 days in group L; P=0.97 and P=0.13, respectively). Although postoperative mortality rates were not different between the two groups (0.8% vs. 0.8%, p=1.0), post-operative complication rate was significantly lower in the group S (11.2% vs. 19.2%, P=0.02). Especially, pulmonary complication rate including pneumonia, ARDS, and prolonged air leakage was significantly lower in the group S (2.5% vs. 8.3%, p<0.01). Postoperative decrease of diffusion capacity (DLco) was significantly lower in the group S (13.1% ± 16.4 vs. 18.2% ± 19.7, P=0.02). Recurrence-free survival (RFS) and overall survival (OS) were not significantly different between patients who underwent lobectomy (5-year RFS, 84.0%; 5-year OS, 90.2%) and segmentectomy (5-year RFS, 89.0%; 5-year OS 88.4%). (Figure 1)wclc 2018 figure1.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      Thoracoscopic segmentectomy could achieve excellent early surgical outcomes with lower complication rates and preserved pulmonary function compared to lobectomy without jeopardizing long-term oncologic outcomes.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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