Virtual Library
Start Your Search
A.A.B.A. Da Costa
Author of
-
+
P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
-
+
P3.01-034 - Long-Term Survival in Metastatic Non-Small Cell Lung Cancer: Predictive Clinical Factors (ID 330)
09:30 - 09:30 | Author(s): A.A.B.A. Da Costa
- Abstract
Background:
While most patients with non-small cell lung cancer (NSCLC) stage IV, presents an unfavorable prognosis, a small proportion presents median overall survival beyond 2 years. The aim of this study is to identify clinical factors associated with long-term survival (LTS) in patients metastatic NSCLC.
Methods:
Single-center, retrospective study performed from the selection of patients in electronic medical records with a diagnosis of NSCLC, metastatic at diagnosis, and treated at AC Camargo Cancer Center in Brazil, from January / 2007 to June / 2014. We compared the group of patients who survived more than two years, the long-term survivors (LTS), to that survived less than two years, the short-term survival (STS), regarding the clinical characteristics and treatments performed. Using the chi-square test (categorical variable), and T test (continuous variables), for univariate analysis and by binary logistic regression model for multivariate analyzes, adopting the significance level P < 0.05
Results:
From 292 patients with stage IV NSCLC, there were 46 (15.7%) patients who survived beyond 2 years, and the remaining 246 patients who survived less than two years, we selected a control group of 46 patients. In the LTS group, the median overall survival (OS) was 39.7 months, and five-year-survival was 10.8%, while in the control group median OS was 9.2 months. In the univariate analysis related to clinical factors, the LTS was associated with female gender (P: 0.03); not smoking (P: 0.013); ≤ 2 metastatic sites (P: 0.02); ECOG of 0-1 (P: 0.01); absence of extra-thoracic metastasis (P: 0.001); absence of liver metastasis (P: 0.004) absence of bone metastasis (P: 0.001); absence of weight loss (P: 0.03); absence of decreased appetite (P: 0.001); and the presence of activating mutation in the EGFR gene (0.024). In univariate analysis regarding factors related to treatment, the LTS was associated with: two or more systemic treatment lines (P: 0.001); partial or complete response in first-line chemotherapy (p = 0.0001); use of tyrosine-kinase inhibitor (p = 0.0001); and maintenance chemotherapy (P: 0.012). In multivariate analysis of clinical factors, were considered long predictors of survival: two or fewer metastatic sites (OR: 7.1; P: 0.008) and ECOG 0-1 (OR: 12.2 P: 0.024). There was a trend for female gender (OR: 3.1 P: 0.057).
Conclusion:
We conclude that, in our sample, patients with stage IV NSCLC who have ECOG 0-1 and oligometastatic disease (≤ 2 sites) are more likely to long-term survival.
-
+
P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
-
+
P3.04-113 - Neutrophil to Lymphocyte Ratio (NLR) at Diagnosis as a Prognostic Marker in Patients with Stage IV Non-Small Cell Lung Cancer (ID 1286)
09:30 - 09:30 | Author(s): A.A.B.A. Da Costa
- Abstract
Background:
Systemic inflammation has been linked with cancer development, cancer cachexia and poor outcome. Neutrophil to lymphocyte ratio (NLR), an index of systemic inflammation, has been associated with worse survival for many types of cancer. The aim of this study is to investigate the clinical significance of the blood NLR as a prognostic factor in non-small cell lung cancer (NSCLC) patients.
Methods:
We retrospectively reviewed the medical charts of patients with metastatic NSCLC, diagnosed between Jan 1st 2011 and July 30th 2014, from a single Brazilian institution. Data on prognostic factors such as histology, gender, performance status, comorbidities and type of treatment were collected. The baseline NLR was assessed just before chemotherapy treatment initiation. NLR was defined as the ratio between the absolute neutrophil and lymphocyte counts. Associations between clinical variables and NLR were tested with Chi-square or exact Fisher´s test. Overall survival (OS) was calculated by the Kaplan–Meier method. Curves were compared using the log-rank test. Multivariate analysis was performed using Cox regression to assess independent patient characteristics associated with OS, and included in the model all variables with p < 0.05 on univariate analysis. All analysis were considered statistically significant when p < 0.05.
Results:
A total of 170 patients were included in the study. Median age was 63.4 years, 54.1% were male, 80.6% had adenocarcinoma, 17.6% had mutated EGFR, 47.6% were former smoker, and 78.2% had ECOG ≤ 1. Median NLR was 4.6. NLR > 4.6 was associated with SNC metastasis. Median follow-up time was 19.64 months and median overall survival was 13.7 months. Patients with NLR > 4.6 had a worse survival. OS was 22.27 months versus 7.03 months (p < 0.001) for patients with NLR ≤ 4.6 and NLR > 4.6, respectively. In multivariate analysis, the NLR remained as an independent prognostic factor for worse OS after adjusting for sex, histology, tumor size and performance status.
Conclusion:
Elevated NLR at diagnosis is an independent predictor of poor OS in patients with advanced NSCLC
