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Poster Session (ID 8)
- Event: ACLC 2018
- Type: Poster Session
- Presentations: 1
- Coordinates: 11/07/2018, 00:00 - 00:00, Poster Hall
P002 - Surgical Resection Improves the Survival of (ID 134)
00:00 - 00:00 | Author(s): B. Zhang
Introduction: Due to the advent of molecular targeted therapy, the therapeutic landscape of advanced NSCLC with certain driver mutations has been changed substantially. Local consolidation therapy with surgery or radiotherapy in combination with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) is believed to achieve longer progression-free survival (PFS) for stage IV NSCLC patients with oligometastases. We investigated whether primary tumor resection in non-small cell lung cancer (NSCLC) patients with ipsilateral pleural dissemination could achieve more clinical benefit during first-line targeted therapy.
Methods: Patients with an initial diagnosis of stage IVa NSCLC who had ipsilateral pleural dissemination and received first-line EGFR-TKIs were included. Overall survival (OS) and progression-free survival (PFS) were analyzed. Median (m)PFS was the primary endpoint.
Results: Patients were divided into three groups: 17 cases in the palliative resection (PR) group, 15 in the video-assisted thoracoscopic surgery (VATS) biopsy (VB) group, and 56 in the pneumocentesis (P) group. Median (m)PFS and mOS for the entire cohort were 15.7 and 37.5 months, respectively. MPFS for PR group was 27.4 months, significantly longer than that for the VB and P groups (15.1 months and 13.3 months, respectively (p<0.05)). The mPFS for patients with primary tumors ? 3.5 cm was 21.4 months, compared with 13.3 months for tumors >3.5 cm (p=0.017). In PFS multivariate analysis, primary tumor length (HR 1.682) and treatment modality (HR 0.795) were possible independent prognostic factors. The mOS and 5-year OS rate for the PR group was 48.0 months and 44.8%, respectively, compared with 37.5 months and 11.3%, respectively, for patients whose tumors were not resected (p=0.130). For patients who received subsequent targeted therapy (n=30) after first progression, mOS and 5-year OS rate were 52.9 months and 48.8%, respectively, compared with 29.6 months and 2.9%, respectively, for patients who received chemotherapy (n=45) (p=0.000). In further OS multivariate analysis, subsequent treatment was the only independent prognostic factor (HR 5.873, 95% CI, 2.694