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EP1.03 - Biology (ID 193)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Biology
- Presentations: 1
- Now Available
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
EP1.03-25 - Impact of Preoperative Complete Blood Cell Count-Derived Inflammation Biomarkers in Early-Staged Non-Small Cell Lung Cancer Patients (Now Available) (ID 705)
08:00 - 18:00 | Presenting Author(s): Fumihiro Shoji
Although stage IA non–small-cell lung cancer (NSCLC) has an optimistic survival rate, up to 10% of these patients relapse after surgery and die. Inflammation plays a critical role in the development and progression of various cancers by promoting cancer cell proliferation and survival, angiogenesis and tumor metastases. Inflammatory cells in the tumor microenvironment significantly affect tumor development, and markers of systemic inflammation may indicate tumor status. In recent years, complete blood cell count (CBC)-derived inflammation biomarkers such as systemic immune-inflammation index (SII), neutrophils lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and monocyte lymphocyte ratio (MLR), are used as prognostic factors in various malignancies. These markers are based on two or three parameters selected among neutrophils, lymphocytes, platelets and monocytes. SII has been investigated as a prognostic factor in several malignancies. NLR, PLR and MLR have been used as markers as systemic inflammation and are associated with poor outcomes in sloid tumors. Concerning non-small cell lung cancer, these parameters have been also reported as poor indicators, but few have specifically studied stage IA disease. We retrospectively analyzed clinicopathological features of patients with stage IA NSCLC to identify recurrence predictors and to investigate effects of preoperative CBC-derived inflammation biomarkers.Method
We selected 311 consecutive patients with stage IA NSCLC treated from April 2006 to December 2012 for this study, and tested their preoperative SII, NLR, PLR and MLR in uni- and multivariate Cox proportional analyses of recurrence free survival (RFS).Result
Preoperative high MLR level was significantly associated with sex, smoking status, postoperative recurrence (P<0.0001, =0.0307 and =0.0146) and preoperative high SII level was only correlated with postoperative recurrence (P= 0.0458), although both NLR and PLR were not found any related factors. Intratumoral vascular invasion (P= 0.0412), intratumoral lymphatic invasion (P= 0.0097) and preoperative MLR level (P= 0.0269) were identified as independent predictors of shorter RFS. Relative risk for preoperative high MLR level patients was 2.259 compared with patients with low MLR level (95% CI: 1.094–5.000). 5-year RFS rate in preoperative high MLR group was significantly lower than that in low MLR group (82.21% vs. 92.05%, p=0.0062).
Preoperative MLR level is a simple and novel predictor of recurrence in patients with stage IA NSCLC.
P2.10 - Prevention and Tobacco Control (ID 176)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Prevention and Tobacco Control
- Presentations: 1
- Now Available
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
P2.10-07 - Does Short-Term Cessation of Smoking Before Lung Resections Reduce the Complication Risk? (Now Available) (ID 1591)
10:15 - 18:15 | Author(s): Fumihiro Shoji
Smoking cessation is one of the most important preoperative preparatory acts before thoracic surgery; however, the optimal timing for preoperative smoking cessation has not been clarified. In this study, we examined the effect of short-term smoking cessation before pulmonary resection for preventing postoperative pulmonary complications (PPCs).Method
We enrolled 753patients who underwent curative surgical resection for thoracic malignancies from 3institutions. We instructed patients with a smoking history to quit smoking by at least four weeks prior to surgery in order to reduce the incidence of pulmonary events. We collected information on the preoperative smoking status, duration of smoking cessation before surgery, and occurrence of postoperative pulmonary complications. Study subjects were classified into three groups based on their smoking status. Recent smokers were defined as any who had smoked within two months before surgery, and former smokers were defined as those who had abstained from smoking for more than two months prior to the operation. Never-smokers were defined as those who had never smoked. We examined the relationship between the duration of the preoperative smoke-free period and the development of PPCs.Result
The mean age of the patients was 68 years old, including 426 males and 327 females. Former smoker accounted for 48% (n =361) of the cases, followed by never smokers (n=287, 38%) and recent smokers (n=105, 14%). Surgery was performed for 660 primary lung cancer and 93 metastatic lung tumor. The types of procedures performed included lobectomy (n=542), pneumonectomy (n=11), wedge resection (n=167) and segmentectomy (n=33). PPCS were observed 62 cases (8%) among all patients. The incidence of PPCS among recent, former and never-smokers was 15%, 8% and 6%, respectively (p=0.01). The mean duration of post-operative chest tube drainage among recent, former and never-smokers 3.2, 2.2 and 2.2 days, respectively (p=0.04). The mean post-operative hospital stay among recent, former and never-smokers was 12.1, 10.6 and 10.2 days, respectively (p=0.07). There were no cases of 30-day mortality.
Cigarette smoking was associated with PPCS such as respiratory failure, pneumonia, empyema, atelectasis and prolonged air leakage. In addition, cigarette smoking generated a harmful effect for post-operative short-term outcome. Smoking abstinence for at least 2 months prior to surgery was not shown to reduce the incidence of PPCs.