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Gustavo De Simone
MA10 - Considerations in Immunotherapy / Real World (ID 911)
- Event: WCLC 2018
- Type: Mini Oral Abstract Session
- Track: Advanced NSCLC
- Presentations: 1
- Coordinates: 9/25/2018, 10:30 - 12:00, Room 105
MA10.09 - NECPAL 2: A Multicentre Descriptive Study of Primary and Continuous Attention in Palliative Care in Argentina: Lung Cancer Cohort (ID 12928)
11:30 - 11:35 | Author(s): Gustavo De Simone
In Argentina Lung cancer is the most deadly neoplasm (9230 annuals death). Early identification of palliative care (PC) needs has proven benefits in terms of quality of life, survival, and decision making in Lung cancer patients. The NECPAL CCOMS-ICO© tool is face and content-validated instrument to identify patients likely in need of PC.a9ded1e5ce5d75814730bb4caaf49419 Method
To implement and evaluate a demonstration multicenter program for early and continuous PC for Lung cancer patients in Buenos Aires using the NECPAL-CCOMS-ICO© tool (multifactorial assessment) in every level of attention. We reported the results of one University Cancer center lung cancer cohort (2016-2018).
We categorized patients as surprise question positive (SQ+), (Would you be surprised if this patient were to die in the next 12 month?). If the healthcare professional answered ‘NO’, the patient was considered SQ+ and they were also considered NECPAL+ when they presented at least one additional parameter from the NECPAL tool. All patients classified as NECPAL+ were considered to be in need of PC. Then using a Cox regression model analyzed predictors for overall survival (OS).4c3880bb027f159e801041b1021e88e8 Result
82 patients out of 206 were SQ+ and NECPAL +. Median age 64 (35-82). 46 % had stage IVB (8th ) ,18 % IVA , 19.5% locally advanced, and 7 ptes early stage. 6 ptes presented SCLC . Male were 59%. 78 ptes were analyzed for overall survival; n=4 were excluded due lost of follow up. 56% had died with a Median OS of 11 months (7.2-14.7). 5/82 ptes did not receive any kind of oncology treatment due ECOG, comorbidities or patients’ choice. Median OS was 17 months (10.5-23.4) for men and 10 months (3.7-16.2) for females (p=0.08).
In the univariate analyses, only metastasis in vital organs (nervous central system, liver, massive lung) was predicted of survival (17 vs 8 months; p=0.035). The other NECPAL indicators did not met the criteria for significance.
The multivariate analysis, did not find a statistically significant combination of predictors for overall survival except metastasis in vital organs. It was noted an small number of low PPS score (11/78), as well as nutritional (14/78) or severe functional deterioration (5/78), in spite of the majority of the cohort had advanced disease.
This Program adds a prospective direct method of measuring prevalence of PC needs including a Palliative approach. The results presented support consideration of the NECPAL tool as a prognostic tool in our setting.
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