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David Lorente
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P3.08 - Oligometastatic NSCLC (Not CME Accredited Session) (ID 974)
- 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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P3.08-06 - Long-Term Survival for Brain-Only Oligometastatic NSCLC Patients Treated with Ablative Therapy (AT): Prognostic Factors (ID 14119)
12:00 - 13:30 | Author(s): David Lorente
- Abstract
Background
Although brain metastasis (BM) have been associated with poor prognosis,brain-only oligometastatic(BOO)-NSCLC patients represent a special population for whom CAT may represent a reasonable therapeutic approach
a9ded1e5ce5d75814730bb4caaf49419 Method
Retrospective cohort with BOO-NSCLC (defined as 1-5 metastases in brain as only metastatic site) treated between 2010-2018 at Hospital La-Fe.Recursive Partitioning Analysis (RPA) group-score was calculated
4c3880bb027f159e801041b1021e88e8 Result
67 patients were identified (Table-1). Median-overall survival (mOS) was 20.2 months (95CI%:11.5-28.9). RPA-group score was associated with OS (HR:5.7;p<0.001); mOS was not reached in RPA-I, 16.2 m (95%CI:8.3-24.1) in RPA-II and 4.5 m ((IC95%:2.2-6.8) in RPA-III. Other factors associated with OS in univariable analysis were: radical treatment of the primary tumor (HR:2.6,p<0.005); radical treatment of the BM (HR:5.6,p<0,001); lymph node involvement (HR:2.17,p=0.031).Radical treatment in both primary and BM was associated with an increased mOS (HR:2.62;p<0,001). In the multivariable model, only RPA-group (HR:1.8 CI95%:2.8-12.7;p<0.0001), radical treatment of BM (HR:1.7;CI95%:2.4-13.1;p<0.0001) and lymph node involvement (HR:0.82;CI95%:1.1-4.9;p=0.03) were associated with an improved survival(table-2).
Table-1.Patients´ characteristics
VARIABLES
ALL PATIENTS
NUMBER
%
Patients enrolled
67
100
Gender
Male
Female
48
19
71.6
28.4
Age
Median (range)
59 (40-85)
---
Pathology
Adenocarcinoma
Squamous
NSCLC NOS
49
8
10
73.1
11.9
14.9
RPA groups
RPA-I
RPA-II
RPA-III
19
39
9
28.4
58.2
9
Brain metastases
Synchronous to diagnosis
Metachronous to diagnosis
47
20
70.1
29.9
Number of brain metastases
1
2
3
4-5
46
11
4
6
68.7
16.4
6
9
Table-2.Univariate and multivariate analysis.
Variable
Survival (months)
Univariate
Multivariate
HR
IC95%
p-value
HR
IC95%
p-value
RPA-I
Not reach
5.7
Not reach
<0.001
1.8
2.8-12.7
<0.0001
RPA-II
16.2
8.3-24.1
RPA-III
4.5
2.2-6.8
Radical treatment of the primary tumor
31.4
2.6
13.7-49.1
<0.005
0.4
0.8-3.4
0.2
No radical treatment of the primary tumor
8.4
3.0-14.4
One BM
24.5
8.7-40.4
>0.5
----
-------
---------
More than one BM
11.4
1-22
radical treatment of the BM
36.2
5.6
15.2-57.2
< 0,001
1.7
2.4-13.1
<0.0001
No radical treatment of the BM
6.5
5.8-7.3
N0-N1
36.7
2.7
Not reach
p=0.031
0.82
1.1-4.9
0.03
N2-N3
16.2
5.2-27.3
Radical treatment in both primary and BM
36.2
2.62
28.1-44.4
<0,001
0.8
0.55-10.69
0.25
No radical treatment in both primary and BM
7.2
3.9-10.5
8eea62084ca7e541d918e823422bd82e Conclusion
A radical approach in patients with stage-IV NSCLC with a limited number of BM may achieve long-term disease control in a subgroup of patients. Patients with RPA-I and II, one-BM, radical treatment, and N0-N1 have improved OS and may be suitable for this approach
6f8b794f3246b0c1e1780bb4d4d5dc53
