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nouha Daoud
Author of
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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.01-58 - Impact of Tumour Size on the Management and Outcome of Stage III Non-Small Cell Lung Cancer (NSCLC) (Now Available) (ID 1940)
08:00 - 18:00 | Author(s): nouha Daoud
- Abstract
Background
We aimed to evaluate the difference in clinical/radiological presentation and patient management according to tumour size in stage III NSCLC. We also reported its impact on patient’s outcome.
Method
We retrospectively studied 88 patients with stage III NSCLC treated between 2010 and mid-2017 in our oncology department. Various cut-off values for tumour diameter were evaluated. We selected a cut-off value of 4 cm, and considered two groups: tumour size≤4 cm and >4 cm. Epidemiological, anatomo-clinical parameters were collected and compared. Kaplan-Meier method was used to evaluate survival.
Result
Differences in characteristics of the two groups were described in table 1.
Initial therapeutic strategy was significantly correlated with tumour size; in tumour≤4 cm therapy was concurrent chemoradiation in 0%, neoadjuvant chemotherapy in 53%, upfront surgery 47% vs 25%, 61%, and 14% respectively for tumour size>4 cm group (p=0.003).
Among patients receiving neoadjuvant chemotherapy, response was not correlated to tumour size; in≤4 cm group we observed (Partial response (PR) 89%, stable disease (SD)11%, Progressive disease(PD) 0%), in >4cm group response was (PR 39%, SD 36%, PD 25%)(p=0.6). Surgery (upfront or after neoadjuvant chemotherapy) was significantly higher in tumour ≤4cm (65% vs 20%) (p=0.0001). Definitive chemoradiation was more indicated in larger tumours, without statistical significance (75% vs 46%)(p=0.4). Therapeutic discordance between the planned and the administered treatment was significantly higher in larger tumours (68% vs 18%) (p=0.0001). Progression free survival was longer in smaller tumours (18±9.3 vs 11±12.1 months) without being statistically significant. However, median overall survival was significantly correlated with tumour size (41.7± 5.1 in ≤4 cm, 32.8±4.6 months in > 4 cm) (p=0.04). The pattern of recurrence was not correlated to tumour size; it was locoregional in 30%, distant in 20% and both locoregional/distant in 50% in≤4 cm group vs 42%, 24%, and 34% respectively in tumour size> 4 cm (p=0.6).
Table 1: Characteristics of patients in the two preselected groups.
ConclusionPatient characteristics
Tumour size ≤4 cm
(n=17)
Tumour size> 4 cm
(n=71)
P
Age at diagnosis
Median ± SD (years)
Elderly (≥70 years),%
Young (<70 years),%
.
59±9.1
6%
94%
.
62.27±10.8
28%
72%
0.25
0.05
Gender, %
Male
Female
.
59%
41%
.
87%
13%
0.006
Performance Status, %
0
1
2
.
6%
94%
0%
.
1%
83%
16%
0.02
Weight loss, %
18%
42%
0.06
Histological type, %
Adenocarcinoma
Squamous cell carcinoma
large cell carcinoma
.
88%
12%
0%
.
47%
52%
1%
0.008
Histological grade, %
Well differentiated
Moderately differentiated
Poorly differentiated
.
18%
76%
6%
.
24%
48%
28%
0.075
T Status, %
T1
T2
T3
T4
.
24%
29%
29%
18%
.
0%
7%
18%
75%
0.0001
N Status,%
N0
N1
N2
N3
.
6%
6%
71%
17%
.
10%
15%
58%
17%
0.67
Stage,%
IIIA
IIIB
.
77%
23%
.
44%
56%
0.015
When taking 4 cm as a cut-off value, tumour size influenced clinical presentation and management modalities. It may be considered as a prognostic factor in stage III NSCLC.
