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Emine Bozkurtlar
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P2.06 - Mesothelioma (ID 170)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Mesothelioma
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.06-22 - Is Laboratory Prognostic Index a Valuable Prognostic Index for Malignant Pleural Mesothelioma? (Now Available) (ID 1445)
10:15 - 18:15 | Author(s): Emine Bozkurtlar
- Abstract
Background
Prognostic significance of Laboratory Prognostic Index (LPI) was demonstrated in non-small cell lung cancer before. We aimed to assess the prognostic value of LPI in patients with malignant pleural mesothelioma (MPM).
Method
Records of MPM patients were examined retrospectively for serum laboratory results at diagnosis along with demographical and clinicopathological features. LPI is consisted of white blood cell count (>10000/mm3), albumin (<3.5 g/dL), lactate dehydrogenase (>248 U/L), alkalene phosphatase (>120 U/L) and calcium (>10.5 mg/dL) levels; and it is graded according to the number of abnormal parameters: 0 (none), 1 (one) and 2 (two or more). Kaplan-Meier method and stratified log-rank test were used in univariate analysis and a Cox regression model was conducted to determine independent predictors of overall survival (OS).
Result
Sixty-one patients were included in the study. Median age at diagnosis was 59 (51-66) years. 45 deaths (73.8%) have occurred at the time of final analysis and median OS was 19.5 months. One-year survival rates for patients with LPI 0, 1 and 2, were 82%, 61% and 59%; 2-year survival rates were 75%, 47% and 24%, respectively. Median OS of patients with LPI 0, 1 and 2 were 36.5, 21.7 and 15.6 months, respectively (p=0.007). Age, ECOG performance status, histology, hemoglobin level and LPI were found to effect OS significantly or to have a trend (p<0.1). In multivariate analysis, LPI (p=0.033) and ECOG performance status (p<0.001) were the independent prognostic factors.
Conclusion
The LPI may be a valuable prognostic factor in mesothelioma as well. Larger studies are needed to confirm this result.
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P2.17 - Treatment of Early Stage/Localized Disease (ID 189)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.17-23 - The Role Adjuvant Chemotherapy in Resected Stage 1 NSCLC with High Risk Factors: A Turkish Oncology Group Study (Now Available) (ID 2301)
10:15 - 18:15 | Author(s): Emine Bozkurtlar
- Abstract
Background
Adjuvant chemotherapy is accepted as a standard treatment for suitable patients who have undergone surgery for T2N0 non-small cell lung cancer with tumors larger than 4 cm. Despite similar relapse rates, the benefit of adjuvant chemotherapy for smaller tumors with high risk features is not clear. In this retrospective analysis our aim was to evaluate the prognostic impact of adjuvant platin-based chemotherapy in high-risk stage 1 NSCLC patients.
Method
This cooperative group study included 250 NSCLC patients who underwent curative surgery for stage 1 NSCLC with tumor size 2-4 cm and adverse prognostic factors consisting of visceral pleural invasion(VPI), lympho-vascular invasion(LVI), high grade, presence of solid-micropapillary(SMP) components or STAS. Records of patients were analyzed to investigate the prognostic impact of adjuvant chemotherapy in this cohort. DFS was defined as the time from surgery to the last follow-up, until relapse or death, CSS;time from surgery to death related to cancer or last known contact, OS;time from diagnosis to death or last known contact. Statistical analysis was performed using SPSS 20.0 software(SPSSInc,Chicago,USA).
Result
Median age at presentation was 63 years (range 18-90). The mean tumor size was 29.4 ± 7.4 mm. The frequency of patients with specified risk factors were: VPI: n: 92 (36.8%); LVI: n: 91 (36.4%); Grade 3:n: 49 (19,6%); SMP:n: 76 (30.4%); STAS:n: 15 (6%). A total of 51 patients had received adjuvant platin-based chemotherapy. There were significantly more patients who received chemotherapy in the younger age group (<65 ears old, ≥65 years old) and those with larger tumors (2 – 3 cm, 3 – 4 cm).
During a median follow-up period of 91.8 months; 79 patients(31.6%) experienced recurrence, 62 patients(24.8%) have died, 144 patients(57.6%) were alive without disease and 24 patients (9.6%) were alive with disease.
5-year and 10-year OS rates were 72.7%(± 3,5) and 46.8%(± 8), respectively. There was a significant improvement in DFS with adjuvant chemotherapy, especially in groups with VPI (93.3% vs 53.6%, p:0.016) and SMP (92.3% vs 57.3%, p:0.03). There was also a non-significant trend for improved CSS and OS among patients who received CT.
Table 1. Effects of chemothrapy on survival. Chemotherapy Group
Events/N Median 5-years DFSNon - treatment Group
Events/N Median 5-years DFSP Value DFS 12/51 NE % 74.9 ± 6.3 81/190 71.1 months % 54 ± 4.2 0,032* CSS 4/49 NE % 89 ± 5 41/179 91.8 months % 76.9 ± 3.8 0,078 OS 10/49 NE %77.4 ± 6.4 51/179 88.9 months % 72.1 ± 4 0,541 *All values are stratified, respecting to significant confounding factors such as age, gender and tumor size.
Conclusion
Adjuvant platin-based chemotherapy should be considered for this subset of patients having high grade tumors, or those with VPI, LVI or solid-micropapillary components. Prospective, randomized trials incorporating clinical and molecular risk factors are required to clarify the role of adjuvant chemotherapy for stage 1 NSCLC patients.
