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J. Wang



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    P1.12 - Poster Session 1 - NSCLC Early Stage (ID 203)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.12-021 - Development and validation of a clinical prediction model for N2 lymph node metastasis in stage I non-small cell lung cancer (ID 2949)

      09:30 - 09:30  |  Author(s): J. Wang

      • Abstract

      Background
      The true incidence of occult N2 lymph node metastasis in patients with clinical stageⅠnon-small cell lung cancer (NSCLC) remains controversial. Estimation of the probability of N2 lymph node metastasis can assist physicians when making diagnosis and treatment decisions.

      Methods
      We reviewed the medical records of 739 patients with computed tomography–defined N0 NSCLC that had an exact Tumor-Node-Metastasis stage after surgery. A random subset of three fourths of the patients (n=554) were selected to develope the prediction model. Logistic regression analysis of the clinical characteristics was used to estimate the independent predictors of N2 lymph node metastasis. A prediction model was then built and internally validated by using cross validation and externally validated by the remaining one fourth(n=185) patients which made up the validation data set. The model was also compared to 2 previously described models.

      Results
      We identified 4 independent predictors of N2 disease: a younger age, larger tumor size, central tumor location, and adenocarcinoma or adenosquamous carcinoma pathology. The model showed good calibration (Hosmer–Lemeshow test: P = .92) with an area under the receiver operating characteristic curve (AUC) of 0.748 (95% confidence interval, 0.687-0.809). The AUC of our model was better than those of the other two models when validated with independent data.

      Table 1 . Multivariate Logistic Regression Analysis
      Variable Regression Coefficient P OR 95%CI Lower 95%CI Upper
      Age -0.032 0.007 0.969 0.957 0.981
      Tumor Size 0.456 <0.001 1.577 1.449 1.705
      Central 1.753
      <0.001
      5.771
      		5.453 6.089
      Adenocarcinoma /mixed 1.787 <0.001 5.970 5.546 6.394
      Constant -2.983 0.001 0.051
      Figure 1 Figure 1. The ROC curves of our model, the VA model and the Fudan model for all patients of group B. The AUC of our model was 0.786 (95% CI, 0.690-0.881); the VA model was 0.673 (95% CI, 0.554-0.792); the Fudan model was 0.757 (95% CI, 0.659-0.885).

      Conclusion
      Our prediction model estimated the pretest probability of N2 disease in computed tomography–defined stageⅠNSCLC and was more accurate than the existing models. Use of our model can be of assistance when making clinical decisions about invasive or expensive mediastinal staging procedures.

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    P3.07 - Poster Session 3 - Surgery (ID 193)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P3.07-026 - A non-interventional study on EGFR mutation status and clinical outcomes of Chinese patients with completely resected lung adenocarcinoma (ICAN study) (ID 2187)

      09:30 - 09:30  |  Author(s): J. Wang

      • Abstract

      Background
      ICAN study (NCT01106781) investigated EGFR mutation status, clinical outcomes and recurrent risk factors in Chinese lung adenocarcinoma (ADC) patients after complete resection. Here we report analysis results for the profile of surgery, adjuvant therapy and 2-year disease free survival (DFS) rate in the real-world practice.

      Methods
      Patients were aged ≥18 years, with histological diagnosed lung ADC, and received surgical complete resection. Tumor sample EGFR mutation status was determined according to clinical routine practice. All eligible patients would be followed up to collect the clinical information and the outcomes till 3 years after operation.

      Results
      Of 571 patients from 26 sites, 315 (55.2%) patients were EGFR mutation positive. The most common mutations were exon19 deletion and L858R mutation found in 140 (24.52%) and 132 (22.59%) patients respectively. There were 50.79% of patients who received adjuvant therapy, in which 45.37% received chemotherapy, 4.55% received radiotherapy and 1.93% received TKI therapy, respectively. The 2-year DFS rate was 68.83%. There was statistically significant difference of 2-year DFS among the patients with different postoperative pathologic stage (P <0.0001). There was no statistically significant difference of 2-year DFS among the patients with age, gender, smoking history and EGFR mutation status. Operation method and adjuvant therapy correlated significantly with 2-year DFS, but was not significant when adjusted for postoperative pathologic stage.

      Conclusion
      The overall EGFR mutation positive rate in operable Chinese ADC was 55.2%. 2-year DFS rate was 68.83%. Postoperative pathologic stage had a statistically significant association with 2-year DFS, while age, gender, smoking history and EGFR mutation status didn’t show statistically significant association.