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B. Koczwara



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    P1.13 - Poster Session 1 - SCLC (ID 200)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.13-003 - Impact of pre-treatment serum lactate dehydrogenase on survival in patients with small cell lung cancer. (ID 1295)

      09:30 - 09:30  |  Author(s): B. Koczwara

      • Abstract

      Background
      Serum lactate dehydrogenase (sLDH) is a prognostic factor in small cell lung cancer (SCLC). The aim of this study was to evaluate the impact of pre-treatment levels on survival in a contemporary patient population with limited disease (LD) and extensive disease (ED).

      Methods
      SCLC patients were identified by searching the hospital cancer registry from 1999 to 2009. Patient characteristics, sLDH, management and outcomes were collated by reviewing clinical records. A sLDH result < 230 was designated normal and a result >230 was designated elevated in line with our institutional reference range. Survival analysis was performed using stata software using cox regression.

      Results
      168 patients were diagnosed with SCLC, 103 males and 65 females. Median patient age was 71 years. Pre-treatment sLDH was available for 128 patients. An elevated sLDH was associated with worse survival with Hazard Ratio (HR) 2.17 (95% CI 1.46-3.20, p-value <0.001). Elevated sLDH remained a significant independent poor prognostic factor in a multivariate model when adjusted for age, sex, treatment and stage. In LD patients 52.6% had an elevated sLDH and median overall survival (MOS) was significantly worse in patients with elevated sLDH compared with normal sLDH, 7.97 months versus 16.50 months (HR 2.1, 95% CI 1.07-4.32, p-value = 0.032). In ED patients 69.4% had an elevated sLDH and MOS was also significantly worse in patients with elevated sLDH compared with normal sLDH, 5.22 months versus 8.23 months (HR 1.8, 95% CI 1.1-2.9, p-value = 0.019). Figure 1Figure 2

      Conclusion
      This study confirms the prognostic significance of sLDH. LD patients with an elevated sLDH had a MOS which was similar to ED patients with a normal sLDH. Further studies to determine the biology of this subgroup of poor prognostic patients will be important to tailor therapeutic strategies.

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    P2.13 - Poster Session 2 - SCLC (ID 201)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.13-007 - Impact of age on treatment and survival in patients with small cell lung cancer. (ID 3210)

      09:30 - 09:30  |  Author(s): B. Koczwara

      • Abstract

      Background
      Elderly patients account for a significant proportion of patients with small cell lung cancer (SCLC). Intuitively advanced age may be associated with worse outcomes. We examined the impact of age of the patients, <70 years versus >70 years, on survival.

      Methods
      Patients with small cell lung cancer (SCLC) were identified by searching the hospital cancer registry from 1999 to 2009. Patient characteristics, management and outcome data were collated by reviewing clinical records. Analysis was performed using SPSS version 20.

      Results
      168 patients with SCLC with a median age of 71 years (range 37-94) were identified of which 49 had limited stage (LS) and 113 had extensive stage (ES) SCLC. Staging was indeterminate in 6 patients. Within the overall cohort 82 patients were <70 years in age and 86 were > 70 years of age. the median survival was 8.5 months in the <70 year cohort (95% CI 5.9 -11.0.) and 5.2 months in the > 70 months cohort (95% CI 3.0-7.3) with p value of 0.02. However, when analysed separately for each stage the survival difference was not significant within the 2 cohorts. Median survival were 12.5 months vs 9.1 month in the LS cohort (p= 0.53) and 5.9 months vs 4.5 months within the ES cohort ( p=0.08). In the LS cohort, there was no significant difference in proportion of patients who received active treatment or completing treatment between the two groups (92.8% vs 95.2% p =1.0) and (70.8% vs 54.5% p = 0.53). In the ES cohort patients higher proportion of patients <70years received active treatment, including chemo-radiotherapy, chemotherapy alone or radiotherapy alone, (78% versus 69%, p= 0.2). Significantly less patients >70years vs <70years completed treatment (20% versus 39% p = 0.032). In an adjusted model using Cox regression, the patient age was not significant prognostic factor when adjusted for ECOG performance status, sex and whether the patients received active treatment or not (p=0.8)

      Conclusion
      Age was not an independent prognostic factor and should not be used as the sole criteria for making therapeutic decisions.