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Seong Yong Park



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    MA02 - Miscellaneous Topics in the Management of Early Stage Lung Cancer (ID 116)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Now Available
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      MA02.03 - Impact of Coexisting Interstitial Lung Disease on Resected Non-Small Cell Lung Cancer Patients (Now Available) (ID 1237)

      10:30 - 12:00  |  Author(s): Seong Yong Park

      • Abstract
      • Presentation
      • Slides

      Background

      Patients with interstitial lung disease(ILD) have higher incidence of lung cancer. Treatment for this group is challenging, and long term outcome is poor. We investigated the outcome of patients with lung cancer and ILD after surgical resection, along with risk factor of survival and acute exacerbation.Patients with interstitial lung disease(ILD) have higher incidence of lung cancer. Treatment for this group is challenging, and long term outcome is poor. We investigated the outcome of patients with lung cancer and ILD after surgical resection, along with risk factor of survival and acute exacerbation.

      Method

      Between Januery 2002 and August 2016, total 3413 patients underwent pulmonary resection for lung cancer, among them 74 patients had combined ILD. The demographics, operative and survival data were reviewed.

      Result

      Mean age was 68±7 years-old for 74 ILD patients. 51 (68.9%) patients received video-assisted thoracic surgery (VATS). Lobectomy and sublobar resection were performed to 58 (78.4%) and 15 (20.3%) patients, respectively. 30 (41.5%) patients experienced respiratory complication during early postoperative period. 30-, 90- days mortality and 5-year survival rate were significantly worse than patients without ILD in the same study period (8.1%, 21%, and 21.2% vs. 1.3%, 3.1%, and 73.8%, respectively, p<0.001). Patients with ILD who experienced respiratory complication showed significantly worse 5-year survival than those who has not (18.2% vs. 44.9%, p<0.001). The leading cause of death was cancer related (47.8%), followed by postoperative complications (23.9%). Among 23 patients who received adjuvant therapy, 10 patients died during or shortly after adjuvant therapy. Open thoracotomy (HR 4.02, p=0.017) was risk factor for respiratory complication. Sublobar resection showed similar survival rate in each stage (stage I, p=0.825 and stage II-III, p=0.633) and lower rate of respiratory complication than lobectomy, although statistically not significant (26.7% vs. 43.1%, p=0.246).

      Conclusion

      Interstitial lung disease increased the risk of pulmonary resection for lung cancer. Thoracotomy was associated with higher rate of respiratory complication. Sublobar resection showed similar survival with lower respiratory complication rate compared to lobectomy. Adjuvant therapy should be considered after careful weighing of risk and benefit.

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    P1.17 - Treatment of Early Stage/Localized Disease (ID 188)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.17-32 - The 8th Editions of the AJCC Staging System in Terms of Predicting Recurrence and Survival in Resected NSCLC Long-Term Survivors (Now Available) (ID 1477)

      09:45 - 18:00  |  Author(s): Seong Yong Park

      • Abstract
      • Slides

      Background

      Lung cancer has a poor prognosis, and the number of long-term survivors (LTSs) is small compared with that of other cancers. There are few studies focusing on late recurrence in long-term survivors with lung cancer. The purpose of this study was to analyze the risk factors for survival and late recurrence in long-term survivors after a disease-free period of 5 years.

      Method

      A retrospective analysis of patients with a disease-free survival of at least 5 years after surgical resection for non-small cell lung cancer between January 1998 and December 2009 was conducted. Patients who received neo-adjuvant therapy, had incomplete resection, were of advanced stages according to the AJCC (American Joint Committee on Cancer) 7th edition (stage IIIb and IV), or missing data were excluded.

      Result

      A total of 648 (41.7 %) of 1,555 patients were enrolled. The median age was 62.6 (range, 21.3–82.2) years. Pathologic N0 (485 patients, 74.8 %) and stage I (394 patients, 60.8 % in 7th and 363 patients, 56.0 % in 8th edition) were the dominant stage. According to the 7th edition, node-positive (N1+N2) status was an independent risk factor only for disease-free survival (HR, hazard ratio, 2.575; p=0.028; CI, confidence interval, 1.107-5.990) on multivariable analysis. By contrast, node-positive was an independent risk factor for both overall survival (HR, hazard ratio, 1.608; p=0.031; CI, confidence interval, 1.043-2.477), and disease-free survival (HR, 2.662; p=0.019; CI, 1.175-6.034) in the 8th edition.

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      Conclusion

      Compared to the 7th edition, nodal stage of the 8th edition seems more appropriate as a risk factor for both overall survival and disease-free survival 5 years after surgical treatment in patients with completely resected non-small cell lung cancer.

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    P1.18 - Treatment of Locoregional Disease - NSCLC (ID 190)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Locoregional Disease - NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.18-26 - Pretreatment Risk Factors for Postoperative Pulmonary Complication After Neoadjuvant Concurrent Chemoradiotherapy for NSCLC (ID 431)

      09:45 - 18:00  |  Author(s): Seong Yong Park

      • Abstract

      Background

      An occurrence of postoperative pulmonary complication (PPC) after neoadjuvant concurrent chemoradiotherapy (CCRT) might be fatal. It is important to stratify the risk of PPCs before the beginning of CCRT to decide treatment plans. This study is performed to investigate characteristics and pretreatment risk factors for PPCs after neoadjuvant CCRT in patients with non-small cell lung cancer (NSCLC).

      Method

      We retrospectively reviewed 95 patients who received curative resection after neoadjuvant CCRT for NSCLC from 2007 to May 2018. Data of pulmonary function test and body mass index (BMI) at the time of the beginning of CCRT were used.

      Result

      The mean age was 59.6 ± 9.7, and male patients were 69.5%. Twenty-one patients suffered from PPCs more than grade II. Pneumonia/adult respiratory distress syndrome (n=13) is the most common PPCs following bronchopleural fistula (n= 6) and atelectasis (n=4). Patient with PPCs had significantly longer hospital stay (with Vs without PPCs, median 8 days [Interquartile range {IQR}, 6-10] vs. 17 days [IQR, 9.5 – 30.5], p<0001), and more operative mortalities (0 % vs. 38.1 %, p<0.001). In multivariate analysis, Age-adjusted charlson comorbidity index score (CCI) (Odd ratio [OR] = 2.967, p=0.002), lower diffusing capacity for carbon monoxide (DLCO) (%) (OR = 0.939, p=0.017), and lower BMI (OR, 0.612, p = 0.006) were adverse risk factors for PPCs (concordance index 0.897).figure_2018-08-30_pretreatment risk factors for postoperative pulmonary complication (ppcs) after neoadjuvant concurrent chemoradiotherapy for non-small cell lung cancer.gif

      Conclusion

      Age-adjusted CCI, lower DLCO, and lower BMI were related to PPCs in patients with NSCLC treated neoadjuvant CCRT and surgery. These risk factors should be considered when to decide neoadjuvant CCRT.