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Hidenobu Iwai



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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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      P3.08-10 - A Retrospective Study of Oligo-Recurrence in Patients with Resected Non-Small Cell Lung Cancer (ID 12951)

      12:00 - 13:30  |  Author(s): Hidenobu Iwai

      • Abstract
      • Slides

      Background

      In recent years, local therapy has been shown to be a first-line treatment for patients with postoperative oligo-recurrence of non-small-cell lung cancer (NSCLC). The aim of this study was to clarify the clinical features and outcomes of patients with postoperative oligo-recurrence of NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Of 230 patients with resected pathological stage IAIIIA NSCLC between 2008 and 2016, 56 who developed recurrence were included in this study. Oligo-recurrence was defined as 1 to 3 loco-regional or distant recurrent lesions restricted to a single organ. Other recurrences were classified as poly-recurrence. Second primary lung cancers and suspected lesions were excluded. Definitive local therapy (DLT) included surgery, stereotactic radiotherapy, and radiotherapy performed with curative intent.

      4c3880bb027f159e801041b1021e88e8 Result

      Oligo-recurrence was identified in 26 (44%) patients, mainly as a solitary recurrence (n = 19, 73%) in regional lymph nodes, lung, brain, bone, or adrenal gland. The pathological stage was IA in 7 patients, IB in 7, IIA in 4, IIB in 1, and IIIA in 7. Histology was adenocarcinoma in 18, squamous cell carcinoma in 6, adenosquamous carcinoma in 1, and large cell neuroendocrine carcinoma (LCNEC) in 1. Epidermal growth factor receptor (EGFR) mutation was positive in 13, anaplastic lymphoma kinase (ALK) mutation was positive in 3, and 10 were unknown. Sixteen (62%) of the 26 patients first received DLT, and 9 (35%) received systemic chemotherapy including EGFR and ALK-tyrosine kinase inhibitors (TKIs). Four patients (lung in 3, adrenal gland in 1) underwent surgical resection, and the remaining 12 patients received stereotactic radiotherapy and radiotherapy. The three-year post-recurrence survival (PRS) after DLT and after systemic chemotherapy was 79.0% and 75.0%, respectively. Neither recurrence location nor initial treatment by DLT or systemic chemotherapy affected PRS in oligo-recurrence patients. There was no significant difference in the time to recurrence of oligo-recurrence patients compared with poly-recurrence (median time to recurrence: 1.49 years vs. 1.32 years, p=0.91). The entire population of oligo-recurrence patients had better PRS than those with poly-recurrence (5-year PRS: 67.9% vs. 9.0%, p<0.01).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Oligo-recurrence of NSCLC is not uncommon. For oligo-recurrence, DLT or systemic chemotherapy should be given because it improves prognosis.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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