Author of

• 12495

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

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12535

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    P3.07-040 - Temporal trends in surgical outcomes for early stage non-small cell lung cancer (ID 2958)

    09:30 - 09:30  |  Author(s): B.C. McCaughan
    • Abstract

    Background
    There has been little investigation of temporal trends in outcomes following resection of early non-small cell lung cancer. Analyses are easily confounded by changes in patient characteristics and variations in background mortality when assessing all-cause survival. This study aimed to evaluate changes in patient characteristics, tumour factors and survival over time.There has been little investigation of temporal trends in outcomes following resection of early non-small cell lung cancer. Analyses are easily confounded by changes in patient characteristics and variations in background mortality when assessing all-cause survival. This study aimed to evaluate changes in patient characteristics, tumour factors and survival over time.

    Methods
    A retrospective analysis of 2816 consecutive pathological stage 1A to 3A patients, treated by surgical resection between 1984 and 2007 was performed. Patients were divided into four 6-year eras by date of surgery. Relative survival probabilities were estimated by era and TNM stage. Expected survival was calculated from national age, sex and period specific mortality rates. Multivariable regression using a generalised linear model with Poisson error was used to estimate the excess hazard of death in each era, using the 1984-1989 cohort as the baseline, controlling for age, sex, extent of resection, margin status, tumour stage and cell type.

    Results
    In later eras, patients were older, had a greater proportion of adenocarcinomas and stage 1A tumours. Relative 5-year survival rates for 1984-1989, 1990-1995, 1996-2001 and 2002-2007 were 45.4, 49.6, 48.5 and 57.9% respectively. There was a significant improvement in 5-year relative survival in the 2002-2007 cohort (Excess hazard ratio 0.62, p<0.001). Age ≥75, increasing TNM stage, positive margins and mixed cell type were also significant prognostic factors. The increased survival demonstrated in the most recent era can be attributed primarily to survival gains in stage IIa/b and stage 3a (Figure). Figure 1

    Conclusion
    Temporal trends in patient characteristics in this series mirror recent epidemiological data for non-small cell lung cancer. After controlling for known confounders and background mortality variation, improved survival was demonstrated for more recent patients. Advances in clinical staging and adjuvant therapy may explain these findings.

• 12736

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  P3.14 - Poster Session 3 - Mesothelioma (ID 197)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Mesothelioma
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12741

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    P3.14-005 - Integrating a well living programme into a support group for EPP survivors and carers (ID 1493)

    09:30 - 09:30  |  Author(s): B.C. McCaughan
    • Abstract

    Background
    A brief review of the quality of life of one group of survivors and carers identified that after EPP the most common symptoms affecting quality of life were fatigue, dyspnoea, insomnia and pain. Survivors struggled to return to normal levels of social and role functioning. Interviews also identified the need to share stories with others survivors. In response to this information a well living programme was integrated into an EPP survivor support group. The aim being: to provide information and develop skills to empower survivors and carers to react and improve their quality of life; to optimize the physical, emotional, and social functioning of survivors; and, to assist carers to perform their role while remaining mindful of their own care need.

    Methods
    Four 1 day support / well living meetings were held during 2012. Each involved invited speakers, fitness assessments (6-minute walk test), and time allocated for networking over food and beverages. Topics included: optimizing living with one lung, physical and respiratory assessments, exploring survivor and carer experiences, mindfulness healing, exploring survivor and carer resilience, creating opportunities for self-attention and nurturing, relating science to the living experience, pain management, writing and music for healing, eating for wellbeing and a goal for 2013. Physiotherapy staff contributed regularly to the meetings.

    Results
    The average meeting attendance was 20 participants consisting, of 50% survivors and 50% carers. Patients responded positively to the physical challenges and set their 2013 goal as participation in a community 7 Km fun walk – The Sydney Bay Walk in August. In 2013, an exercise physiologist has worked individually with some group members, either face-to-face or via telephone. This encouraged increased aerobic and resistance training. A number of survivors report improvements in overall fitness, enjoyment of daily living and satisfaction with life.

    Conclusion
    There appears to be consistent changes in participant confidence, and attitude toward physical fitness leading to improved enjoyment of life. The support group is an important link between long term survivors, those currently being treated and a valuable resource for new patients deciding about EPP.