Virtual Library
Start Your Search
Sunatee Sa-nguansai
Author of
-
+
EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
-
+
EP1.15-02 - Thymic Epithelial Neoplasm: A 15-Year Experience Treatment in Rajavithi Hospital, Thailand (Now Available) (ID 583)
08:00 - 18:00 | Author(s): Sunatee Sa-nguansai
- Abstract
Background
Due to the rarity and indolent natural history of thymic tumors, the prospective randomized trials have been lacking. Surgery is the primary treatment for localized disease and chemotherapy may be indicated in advanced disease. We performed a retrospective review of all cases over a 15-year period at our institution.
Method
We retrospectively evaluated all patients who were diagnosed as thymoma and thymic carcinoma during 2003-2017 at Rajavithi hospital. Clinical characteristics, staging, treatment, and outcomes were collected and analyzed.
Result
Thymic epithelial neoplasms were identified in 60 patients: 52.0% male with a median age 56.5 years (range, 22-83 years), 87.0% with Eastern Cooperative Oncology Group performance status of 0 to 1. Paraneoplastic syndromes were presented in 21.7%. The distribution by WHO histologic classification was A, 3.3%; AB, 8.3%; B1, 25.0%; B2, 15.0%; B3, 15.0%; C, 1.7%; and thymoma unclassified, 31.7%. The majorities (55%) of patients were stage 1-3. Of 40 patients who underwent operation, 47.5% underwent R0 resection. Nineteen patients received adjuvant radiation and 5 patients received adjuvant chemotherapy. Palliative chemotherapy and radiation were given in 12 and 7 patients, respectively. The overall response rate to palliative chemotherapy was 10/12 (83.3%) with majority (75.0%) of patients received carboplatin plus paclitaxel.
After a median follow-up of 26.8 (1-180) months, 53 (88.3%) patients remain alive. Median overall survival (OS) was 79.6 months with OS rate at 5-year being 73.6%. Ability to received surgical resection was the only significant (p = 0.003) prognostic factor on multivariate analysis.
Figure Kaplan-Meier curve for overall survival in thymic malignancy patients (N=60), comparison by the ability to receive surgical treatment
Conclusion
Although surgical resection is the mainstay of treatment, it remains clear that these tumors are chemo-sensitive diseases. Traditional cytotoxic agents remain the standard of care in patients with advanced disease. Multidisciplinary approach should be offered in all patients.
-
+
EP1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 206)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
-
+
EP1.16-19 - Expected Years of Life Loss and Survival Outcome in Non-Small Cell Lung Cancer Patients in Rajavithi Hospital (Now Available) (ID 1599)
08:00 - 18:00 | Presenting Author(s): Sunatee Sa-nguansai
- Abstract
Background
To determine expected years of life loss (EYLL) that was the burden of disease parameter of all stages non-small cell lung cancer (NSCLC) patients, survival outcomes in advanced NSCLC patients and association between clinical prognostic factors and survival outcomes in advanced diseases.
Method
This retrospective cohort study was conducted by reviewing 305 eligible all stages NSCLC patients treated at Oncology Unit, Department of Medicine, Rajavithi hospital from 2011 to 2015. The iSQoL statistical package was used to evaluate EYLL compared to the reference Thai population. For advanced NSCLC patients, univariate and multivariate analysis were used to determine prognostic factors associated with survival outcomes.
Result
Total 305 patients were included for EYLL analysis. From survival extrapolation, corresponding EYLL of stage I, II, III, and IV NSCLC patients were 9.20, 15.61, 18.03, 20.23 years, respectively. Male patients had EYLL less than female patients (18.81 years vs 20.70 years). In advanced NSCLC, 261 patients were included in survival and prognostic factors analysis. The median overall survival was 6.08 months. The clinical parameters associated with poor survival outcomes in multivariate analysis were male gender (HR 1.71; p = 0.017), presentation with cough or hemoptysis (HR 1.81; p < 0.001), significant weight loss (HR 1.80; p < 0.001), SVC obstruction (HR 1.98; p = 0.019), pathological fracture (HR 2.16; p = 0.002), symptomatic brain metastasis (HR 2.05; p = 0.005), pericardial metastasis (HR 1.88; p = 0.015), adrenal metastasis (HR 1.58; p = 0.011), and not received palliative chemotherapy (HR 6.18; p < 0.001).
Conclusion
Diagnosis and treating patients with NSCLC as early as possible would be save more life-years from 18 – 20 years in advanced disease to 9 – 15 years in early stage disease. In advanced NSCLC patients, palliative chemotherapy was the most important factor related to better survival outcomes.
-
+
MA19 - Looking at PROs in Greater Detail - What Patients Actually Want and Expect (ID 147)
- Event: WCLC 2019
- Type: Mini Oral Session
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:Joaquim Bosch-Barrera, Virginia Calvo De Juan
- Coordinates: 9/10/2019, 11:30 - 13:00, Interlaken (1988)
-
+
MA19.10 - Estimation of Quality-Adjusted Life Expectancy for Stage and Systemic Treatment in Non-Small Cell Lung Cancer in Rajavithi Hospital, Thailand (Now Available) (ID 585)
11:30 - 13:00 | Presenting Author(s): Sunatee Sa-nguansai
- Abstract
- Presentation
Background
Owing to the high mortality and rapidly growing costs related to lung cancer, it is worth examining the health benefits of treatment in this cancer. This study attempts to quantify the real-life practice quality-adjusted life expectancy (QALE) of non-small cell lung cancer (NSCLC) patients with different stages and systemic treatments.
Method
This cross-sectional study was conducted by reviewing and collected quality of life (QoL) data from 256 eligible all stages NSCLC patients treated at Rajavithi hospital from May 1st to October 31st, 2018. The iSQoL statistical package was used to evaluate QALE compared with the reference Thai population in different stage of disease. For advanced stage, QALE was compared among treatment groups (chemotherapy and Epidermal growth factor receptor tyrosine kinase inhibitors; EGFR TKIs)
Result
The QALE for patients with early and advanced stage NSCLC were 4.49 ± 0.43 and 1.03 ± 0.08 QALY, with the corresponding loss-of-QALE were 14.02 ± 0.44 and 20.13 ± 0.09 QALY, respectively. The difference of QALE between early and advanced stage was 3.46 QALY (p<0.001).
Based on systemic treatment in advanced stage, The QALE for patients who received chemotherapy and TKIs were 1.05 ± 0.08 and 2.19 ±0.28 QALY, with the corresponding loss-of-QALE were 20.48 ± 0.09 and 19.12 ± 0.29 QALY, respectively. The difference of QALE between treatment with chemotherapy and TKIs was 1.17 QALY (Figure, p=0.001).
Conclusion
The utility gained from treatment with TKIs in advanced NSCLC is substantial. Early stage had better QALE than advanced stage NSCLC patients.Future study will assess the cost-effectiveness of targeted therapy in Thailand.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
