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Hwan Il Kim



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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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      P3.01-82 - Survival Impact of Surgery in the Treatment of Stage IIIB-IVA Non-Small Cell Lung Cancer (ID 12121)

      12:00 - 13:30  |  Author(s): Hwan Il Kim

      • Abstract
      • Slides

      Background

      Surgery is usually not indicated in far advanced stage non-small cell lung cancer (NSCLC), but a few recent clinical trials demonstrated aggressive local therapy such as (chemo) radiotherapy or surgical resection improved survival outcomes in oligometastatic NSCLC. This study aimed to evaluate survival impact of cytoreductive surgery in stage IIIB-IVA (based on the 8th TNM classification) NSCLC in the era of effective anticancer drugs.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Patients with stage IIIB, IIIC or IVA NSCLC was recruited from the Hallym Lung Cancer Registry for this retrospective analysis. Other eligibility criteria were ECOG performance 0-1, age under 85 years old and good adherence to lung cancer treatment.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 203 patients were analyzed. All the patients received adequate anticancer drugs during their disease courses. Twenty-two patients (10.8%) received cytoreductive surgery. Significantly better overall survival (OS) was observed in surgery group compared with non-surgery group; Kaplan-Meier estimation for OS was 33.1 months [95% CI, 15.6-50.6] vs. 16.6 months [14.0-19.2] (p=0.007). The Cox proportional hazard ratio (HR) for death was 0.528 [0.290-0.961] (p=0.037) in surgery group when it was analyzed with covariates such as age, sex, performance, histology, stage, and smoking status. ECOG performance 0 and adenocarcinoma histology were also revealed as independent favorable prognostic factors for OS (HR .0.660 [0.474-0.919], p=0.014 and HR 0.481 [0.328-0.707], p<0.001, respectively).

      Table. Cox proportional hazard ratio for death

      Variable HR [95% CI] p-value
      AGE < 65 y.o. vs. ≥ 65 y.o. 0.722 0.520-1.002 0.052
      Sex Female vs. Male 1.950 0.955-3.984 0.067
      ECOG performance 0 vs. 1 0.660 0.474-0.919 0.014
      Histology ADC vs. non-ADC 0.481 0.328-0.707 <0.001
      Stage IIIB/C vs, IVA 0.761 0.520-1.114 0.160
      Smoking ≤ 10 p.y. vs. > 10 p.y. 0.488 0.145-1.639 0.246
      Surgery (+) vs. (-) 0.528 0.290-0.961 0.037

      8eea62084ca7e541d918e823422bd82e Conclusion

      Surgery backed up with adequate anticancer treatments may be a treatment option in far advanced stage NSCLC.

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