Author of

• 31780

  +

  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
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31789

    +

    P2.17-07 - Role of Adjuvant Chemotherapy After Sublobar Resection in Stage I NSCLC (ID 672)

    10:15 - 18:15  |  Author(s): Benjamin Resio
    • Abstract
    • Slides

    Background
    

    Adjuvant chemotherapy (AC) has been associated with improved survival for several subsets of surgically managed NSCLC (e.g. nodal metastases, tumors >4cm). The surgical practice of removing less than the entire lobe (“sublobar resection”) has been associated with increased risk of NSCLC recurrence, yet the impact of AC in this subset is unknown. Stage I NSCLC patients managed by sublobar resection (SR) in the National Cancer Data Base (NCDB) were studied to evaluate SR as a potential indication for AC.

    Method
    

    The NCDB was queried for completely resected (R0) stage I NSCLC patients who underwent multi-agent AC after SR (wedge resection or segmentectomy) between 2004 & 2014. Survival was calculated from 30 days after surgery to minimize immortal time bias. Multivariable Cox proportional hazards models adjusting for patient, tumor (including visceral pleura invasion (VPI) and lympho-vascular invasion (LVI)) and treatment characteristics were created and stratified by size (0-1 cm, 1.1-2 cm, 2.1-3 cm and 3.1-4 cm).

    Result
    

    Of the 12,063 patients identified, 584 (4.84%) received multi-agent AC. AC patients tended to be younger (median age 66 vs 71 years, p<0.001), privately insured (35.13% vs 23.05%, p<0.001), and with high risk pathological features (VPI: 6.47% vs 4.55%, p<0.001, LVI: 10.32% vs 5.70%, p<0.001, high grade: 47.15% vs 34.50%, p<0.001). In patients with tumors measuring ≤3 cm, AC was not significantly associated with a mortality reduction (Table 1). In patients with tumors measuring 3.1-4 cm (N=1,172), AC (N=145, 12.37%) was associated with a lower mortality (HR 0.65, 95% CI 0.48 to 0.87, p=0.003) (Figure 1).

    

    

    Conclusion
    

    The administration of AC was associated with superior survival in stage I NSCLC patients who underwent SR, but only those with tumors 3.1-4 cm. Additional study to validate SR as an indication for AC in stage I NSCLC patients is indicated.

    Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.