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Houda El Benna



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      94P - Challenges in the management of stage III non-small cell lung cancer (NSCLC) within multidisciplinary team (MDT): A lung cancer center experience (ID 562)

      12:30 - 13:00  |  Author(s): Houda El Benna

      • Abstract
      • Slides

      Background

      We aimed to report patterns of care and difficulties during the management of patients with newly diagnosed stage III NSCLC who were presented at our MDT meeting.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Medical records of 88 patients diagnosed with stage III NSCLC between 2011-2017 presented at least once at our weekly lung cancer MDT meeting, were reviewed. Tumor characteristics and treatment receipt were described.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Median age was 61 years old, with a disease stage: IIIA in 48 % and IIIB 52% before MDT meeting. We observed 27.3% of patients referred without histological diagnosis; median delay time from first visit to having a histological diagnosis was 17 days. Median time from first visit to presentation at MDT meeting was 11.8 days (SD = 15.3), and to the start of first therapy was 21.4 days (DS = 43.5). TNM stage was reconsidered after the MDT meeting in 16 % of cases. Treatment decision was upfront surgery in 20%, neoadjuvant chemotherapy (NACT) in 59 %, concurrent chemoradiation (CCRT) in 20%. MDT indications were in adherence to ESMO guidelines in 90 %. Treatment receipt was 81 % for surgery, 84% for NACT and 44% for CCRT. For NACT, the median delay between MDT presentation and start of therapy was 19 days, 15 days for surgery and 19 days for CCRT. Discordance between the planned and administered treatment was recorded in 58% of cases. The reasons for discordance were: 14% patient’s refusal, 8% patient’s general condition decline, 4% of cases for medical contraindications, 8% for the delay in radiation therapy initiation, and lost to follow up in 33 % of cases. Progression occurred during the planned treatment in 23% of cases and 10% of patients died before the end of the planned therapy. The MDT meeting was consulted for the same patient twice in 41% of cases, 3 times 1%. We observed a statistically significant difference between patients who had their treatment as decided by the MDT meeting with 49 months median overall survival versus 22 months in non-adherent patients (p < 0.01).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Management of stage III NSCLC within a MDT showed a role in staging assessment and was characterized by a relatively rapid start of therapy and high impact on survival but a low receipt rate for CCRT.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      Medical Oncology Department Abderrahmen Mami Hospital.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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