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K. Yokoi



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    P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P1.02-024 - Conditional Survival after Surgical Treatment of Non-Small Cell Lung Cancer (ID 1143)

      09:30 - 09:30  |  Author(s): K. Yokoi

      • Abstract
      • Slides

      Background:
      Conditional survival (CS) is an estimate of survival probability for patients who have already survived at least 1 year after diagnosis or treatment. This study was intended to find some useful informations in postoperative follow-up plan by CS analyses of resected non-small lung cancer patients.

      Methods:
      We retrospectively analyzed data on the clinicopathological features and survival outcomes of 925 patients with non-small cell lung cancer who had undergone complete resection at Nagoya University Hospital between 2005 and 2012. CS is the probability of surviving additional time (y) after already surviving time (x), and can be calculated from the following formula: CS(y|x) = S(x+y)/S(x), where S(t) is the overall survival at time (t). In this study, two methods of CS analyses were performed. Briefly, CS(5|x), which meant 5-year conditional survival (5Y-CS(x)), and CS(5-x|x), which was the probability of surviving when five years has passed from surgery (CS5(x)), were calculated in the various setting or subgroups.

      Results:
      The cohort consisted of 624 males and 301 females, ranging in age 26 to 89. The 5-year overall survival rate of all patients was 76%. 5Y-CS(1,2,3,4) was 74, 76, 77, 80%, respecively, showing gradually improvement. This meant that the given treatment for NSCLC including surgery contributed the survival of the patients to some degree. However, the 5Y-CS did not approach 100%, which indicated a certain number of patients coninued to die during the follow-up period. The CS5(1, 2, 3, 4) in all patients were 79%, 84%, 90% and 96%, respectively, which meant the 90% of patients who were alive at 3 years after surgery would survive for next 2 years. The patients with younger female (≤ 70 years), no or light smoker, adenocarcinoma histology, pathologocal stage I and normal serum carcinoembryonal antigen level showed the CS5(3) higher than 90%. Both CS5(3) and 5Y-CS(3) of the patients with all the six favorable factors reached 98%.

      Conclusion:
      Postoperative follow-up visit after 3 years from surgery might be minimum for the patients with younger female, no or light smoker, adenocarcinoma histology, pathological stage I, and normal serum carcinoembryonic antigen level.

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    P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Biology, Pathology, and Molecular Testing
    • Presentations: 1
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      P3.04-128 - Does the Amount of Malignant Pleural Effusion Affect the Survival in Patients with Non-Small Cell Lung Cancer? (ID 573)

      09:30 - 09:30  |  Author(s): K. Yokoi

      • Abstract
      • Slides

      Background:
      Malignant pleuritis in non-small cell lung cancer (NSCLC) is uniformly classified as M1a/stage IV disease according to the 7[th] TNM classification irrespective of its amount of malignant pleural effusion (MPE) and is considered as an incurable disease condition. Although it has been reported that small amount of MPE might be an early phase of malignant pleuritis, its clinical relevance has rarely been studied. Therefore, we examined an impact of the amount of MPE on the survival in patients with NSCLC.

      Methods:
      Sixty NSCLC patients with malignant pleuritis were treated in our institution between 2005 and 2012. By the amount of MPE on chest high resolution computed tomography (HRCT) scans, the patients were classified into the three groups: no MPE (E0, n=21), small amount of MPE (<1.0 cm thick on HRCT) (E1, n=19), and large amount of MPE (≥1.0 cm thick on HRCT) (E2, n=20). Clinicopathological factors including the amount of MPE were investigated for the association between the amount of MPE with the survival regardless of the treatment.

      Results:
      The E2 group correlated significantly with shorter survival than did the E0 and the E1 groups (median survival time, 16, 31 and 20 months, respectively; log-rank P<.01), but there was no significant difference between the E0 and E1 groups. In the univariate analysis, the amount of MPE (E0 + E1 vs E2), histopathological type (adenocarcinoma vs others), treatment (chemotherapy or surgery vs best supportive care) and EGFR mutation (positive vs negative) were significant prognostic factors. After full adjustment with other variables, the amount of MPE, histopathological type and EGFR mutation remained as significant prognostic factors.

      Conclusion:
      The amount of MPE in NSCLC might be an important prognostic factor and affect the patients’ survivals. We suppose the present TNM classification, which uniformly define MPE as M1a/IV status irrespective of the amount of MPE, is necessary to be reconsidered.

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