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Xiaolong Fu
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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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EP1.01-34 - A Retrospective Study of the Pattern of Lymph Node Metastasis in Superior Sulcus Non-Small-Cell Lung Cancers (Now Available) (ID 1742)
08:00 - 18:00 | Author(s): Xiaolong Fu
- Abstract
Background
By comparing the probability of lymph node metastasis between superior sulcus non–small-cell lung cancers (SS NSCLC) and non-SS NSCLC located in the pulmonary apex, we hope to find out whether there is a unique pattern of lymph node metastasis in SS NSCLC.
Method
During 2008-2014, a retrospective study was performed on NSCLC patients with lesions located in the pulmonary apex. Patients with lesions invading the peripheral tissue structure were enrolled in the SS NSCLC group, while those without lesions invading the peripheral structure were enrolled in the non-SS NSCLC group. A total of 65 patients in the SS NSCLC group received surgery, and all patients in the non-SS NSCLC group received surgery. According to postoperative pathology and enhanced CT before treatment, the location and number of lymph node metastasis were determined. The chi-square test was used to statistically analyze the difference in the probability of N1, N2 and distant metastasis (DM) between the two groups.
Result
Compared with the non-SS NSCLC group, the T staging of SS NSCLC group was advanced, but the rate of N1 lymph node metastasis was similar. However, the N2 lymph node metastasis rate of the SS NSCLC was significantly lower than that of the non-SS NSCLC, which was 25.3% and 39.8% respectively (P=0.048). Distant metastasis rates were similar at lower levels in both groups，which was 9.3% and 6.4% respectively (P=0.471).
Table Basic information and results SS NSCLC N0n-SS NSCLC P value Chi-square Gender male 67 65 female 8 28 Median age 61(37-87) 62（42-82） ad 27 67 Pathology squ 32 16 others 16 10 T stage T3+T4 75(100%) 3(3.2%) 0.000* 156.328 N1 25(33.3%) 33(35.8%) 0.771 0.085 N2 19(25.3%) 37(39.8%) 0.048* 3.902 DM 7(9.3%) 6(6.4%) 0.471 0.519 Ad：adenocarcinoma squ: squamous carcinoma DM：distant metastasis
* P<0.05. There were significant differences between the two groups.
Conclusion
Although T staging was very late in SS NSCLC, the N2 lymph node metastasis rate and distant metastasis rate did not increase correspondingly. Therefore, enhanced local treatment, such as neoadjuvant concurrent chemoradiotherapy combined with surgery, may lead to better survival benefits.
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P1.12 - Small Cell Lung Cancer/NET (ID 179)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.12-24 - Comparison of Four Prognostic Scores for Patients with Brain Metastases from Small-Cell Lung Cancer (Now Available) (ID 1851)
09:45 - 18:00 | Author(s): Xiaolong Fu
- Abstract
Background
Prognostic indexes are useful to guide tailored treatment strategies for cancer patients with brain metastases(BMs). Primary tumors have different biological behavior justifying separate scoring systems for different tumors. The purpose of this study was to compare four prognostic scores [recursive partitioning analysis(RPA), graded prognostic assessment(GPA), score index for radiosurgery(SIR), and basic score for brain metastases(BSBM)] for patients with BMs from small-cell lung cancer(SCLC).
Method
Pathological diagnosis of SCLC patients with radiologically confirmed BMs were enrolled except those who received surgery of primary lesion. Clinical data, including age, KPS, primary tumor control, extracranial disease status, number of BMs, systemic disease status, and the largest lesion volume were recorded. The score of RPA, GPA, SIR and BSBM were calculated separately. Overall Survival(OS) was calculated from the date of diagnosis of BMs to the date of death from any case, or the last follow-up. OS was estimated by the Kaplan-Meier method. Cox’s regression analysis was performed using a backward elimination approach to determine the best model predicting survival. P<0.05 was considered statistically significant.
Result
From Jan 2011 to Oct 2014, 224 patients were eligible for the study. For the entire cohort, median OS was 9 months (95%CI, 7.7-10.3). The median survival was 10 months for RPA Class I, 9 months for RPA Class II, and 4 months for RPA Class III(P=0.039). Using the SIR, the median survival was 11, 9, and 6 months for a score of 8-10, 4-7, and 0-3, respectively(P=0.008). In addition, the median survival was 10 months for GPA Class I, 12 months for GPA Class II, 8 months for GPA Class III, and 6 months for GPA Class IV(P=0.136). Using the BSBM, the median survival was 10, 8, 9, and 4 months for a score of 3, 2, 1, and 0, respectively(P=0.099). The backward elimination model in multivariate Cox analysis identified SIR as the only variable significantly associated with survival(P=0.012).
Number of patients OS P RPA I 31 10±1.4 0.039 RPA II 184 9±0.7 RPA III 9 4±0.4 GPA I 22 10±1.4 0.136 GPA II 30 12±2.2 GPA III 136 8±0.8 GPA IV 36 6±1.3 BSBM 0 6 4±1.2 0.099 BSBM 1 85 9±1.3 BSBM 2 88 8±0.7 BSBM 3 45 10±0.7 SIR I 14 11±2.5 0.008 SIR II 182 9±0.7 SIR III 28 6±1.3
Conclusion
The SIR score was more prognostic than the RPA, GPA, and BSBM scores. For patients with BMs from SCLC, SIR was the most accurate for estimating survival. As it was mainly used for radiosurgery in BMs, maybe a new disease-specific prognostic score should be generated in this particular population.
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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
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.18-13 - Predicting Failure Patterns in Patients with Inoperable Local Advanced Non-Small Cell Lung Cancer Receiving Definitive Chemoradiotherapy (Now Available) (ID 1240)
09:45 - 18:00 | Author(s): Xiaolong Fu
- Abstract
Background
To analyze patterns of failure for patients with local advanced non-small cell lung cancer (LA-NSCLC) receiving definitive chemoradiotherapy and to build a nomogram for predicting the failure patterns in these patients.
Method
Clinicopathological materials of patients between 2013 and 2016 with LA-NSCLC who receiving definitive chemoradiotherapy and following-up in our hospital were collected. The endpoint was the first failure after definitive chemoradiotherapy. Based on logistic regression, the predictive value of each factor was evaluated and nomogram was built. This model was validated by ROC curve, calibration curve and decision curve analysis (DCA).
Result
With a median follow-up of 28 month, 100 patients were observed failure. Local failure and distant failure were 46 and 54, respectively. Univariate and multivariate analysis indicated that age (p = 0.016, OR (95%CI): 0.936 (0.887-0.987)), tumor location (p = 0.025, OR (95%CI): 2.732 (1.137-6.567)) and epidermal growth factor receptor (EGFR) mutation status (p = 0.020, OR (95%CI): 3.747 (1.234-11.381)) were independent predictors of distant failure, which were included in the nomogram (Figure 1). ROC curve showed that area under the ROC curve (AUC) of the nomogram was 0.713, which was better than any factors along. Calibration curve revealed a satisfactory consistency between the predicted distant failure and actual observation. DCA showed the majority of the threshold probabilities in this model were with good net benefits (Figure 2).
Conclusion
We concluded that age, tumor location and EGFR mutation status could predict failure pattern in patients with LA-NSCLC receiving definitive chemoradiotherapy. A nomogram was built and validated based on these factors, showing a potential predictive value in clinical practice.
