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Xinyan Xu
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P1.17 - Treatment of Early Stage/Localized Disease (ID 188)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.17-18 - Surgery Alone or Plus Adjuvant Radiotherapy for Patients with N0 Non-Small-Cell Lung Cancer >5 cm: A Population-Based Study (Now Available) (ID 1077)
09:45 - 18:00 | Author(s): Xinyan Xu
- Abstract
Background
According to the eighth edition of the TNM classification for Lung Cancer, T2b (5–7 cm) and T3 (>7 cm) non-small cell lung cancers (NSCLC) should be reclassified as T3 and T4. Here, we evaluated the effect of surgery alone or surgery plus adjuvant radiation (SART) on survival in node-negative patients with NSCLC >5 cm.
Method
We identified 4557 N0 patients with NSCLC >5 cm from the Surveillance, Epidemiology, and End Results database between 2004 and 2014. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared between patients who underwent surgery alone and those receiving SART. The proportional hazards model was used to evaluate multiple prognostic factors.
Result
After propensity-score matching, 1042 and 525 patients were included in the surgery alone and SART groups, respectively. OS and LCSS favored surgery alone over SART. In the multivariate analysis, dissection of ≥6 lymph nodes was associated with better OS and LCSS in patients with NSCLC >5 cm, especially in patients treated with surgery alone. Lobectomy was associated with better OS and LCSS in NSCLC 5–7 cm, whereas it was not significantly superior over sublobectomy in NSCLC >7 cm.
Conclusion
Surgery alone with a number of examined lymph nodes greater than six should be recommended as the first choice for patients with NSCLC >5 cm. Lobectomy should be recommended for patients with NSCLC 5-7 cm. For patients with NSCLC >7 cm who do not tolerate lobectomy, sublobectomy might be an alternative surgical procedure.
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P2.12 - Small Cell Lung Cancer/NET (ID 180)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.12-12 - Nomograms to Predict Survival in Patients with Limited Stage Small Cell Lung Cancer Treated with Definitive Chemoradiotherapy (Now Available) (ID 299)
10:15 - 18:15 | Author(s): Xinyan Xu
- Abstract
Background
To build nomograms to predict progression-free survival (PFS) as well as overall survival (OS) in patients with limited stage small cell lung cancer (LS-SCLC) treated with definitive chemoradiation.
Method
A total of 170 patients treated with chemotherapy and hypo- (HypoTRT) (n = 69) or conventionally (ConvTRT) (n = 101) fractionated radiotherapy between 2010 and 2013 were included. Primary endpoints were progression-free survival (PFS) and overall survival (OS). The prognostic effects of variables were analyzed using Kaplan–Meier method and Cox regression model. Nomograms were established for estimating 1-, 2- and 3-year OS and PFS based on Cox regression model. The utility of the proposed model was evaluated using the time-dependent ROC and area under ROC (AUC).
Result
The survival analysis showed no difference between HypoTRT and ConvTRT combined with chemotherapy. However, regard with the chemoradiotherapy (CRT) modality, the median PFS and OS were 19.4 and 33.0 months in the concurrent group, which was significantly better than those in the sequential group (PFS 12.2 months, p=0.012, OS 20.1 months, p<0.001). According to the multivariate analysis, the final nomograms for OS and PFS were developed. Two nomograms shared common variables including gender, CRT modality, prophylactic cranial irradiation (PCI) and TNM stage, while age at diagnosis, smoking status and chemotherapy circle were only incorporated in the OS nomogram. Nomograms showed better performance than TNM algorithm (3-year AUC for OS: TNM, 0.569; nomogram, 0.832; 3-year AUC for PFS: TNM, 0.572; nomogram, 0.761).
Conclusion
Our nomograms are reliable and powerful tools for distinguishing and predicting the survival of LS-SCLC treated with definitive chemoradiation, thus helping to better select medical examinations and optimize treatment options in collaboration with medical oncologists.
