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J. Tang



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    P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P3.02-008 - Clinical Characteristics of EML4-ALK Positive and Surgically Resected NSCLC Patients (ID 391)

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

      • Abstract
      • Slides

      Background:
      Along with the research progress of lung cancer-related driver genes, echinoderm microtubule-associated protein-like 4- anaplastic lymphoma kinas(EML4-ALK) positive non-small cell lung cancer(NSCLC), which is a distinctive molecular subtype, has been concerned. In this study we evaluate the clinical features of EML4-ALK positive and postoperative NSCLC patients.

      Methods:
      Clinical data of 42 patients with EML4-ALK positive, postsurgical NSCLC were retrospectively analyized. The organs of distant metastasis were observed. Log-rank test were used to analyse the relationship between clinical characteristics and disease free survival(DFS), overall survival(OS).

      Results:
      EML4-ALK positive patients are raletive young, most of them are never-smokers, peripheral type. The tumors were either moderately or poorly differentiated. The most common organ of distant metastasis was brain. Much more brain metastasis occurred in center type patients than in peripheral type patients(70.0% vs 30.0%,P=0.004).The median time from operation to brain metastasis was 17.2 months. The median post brain metastasis OS was 9.4 months. The DFS of earlier stage, peripheral type, moderately differentiated, without lymph node metastasis and with adjuvant treatment patients were significant longer than those of later stage(30.3months vs 12.8 months, P=0.016), center type(27.4months vs 7.3months, P=0.000), poorly differentiated(27.0 months vs 11.9months, P=0.048), with lymph node metastasis(30.0months vs 12.8months, P=0.027) and without adjuvant treatment(19.1months vs 1.8months, P=0.000) patients. Earlier stage, peripheral type, with adjuvant treatment patients obtained longer OS than later stage, center type, without adjuvant treatment counterparts(respectively 55.5months vs 26.2months,P=0.025; 39.2months vs 20.9 months, P=0.003; 33.4months vs 15.7months,P=0.001). Tab 1 Clinical characteristics of paients

      Characteristics No. of patients Percent(%)
      Gender
      Male 23 54.8
      Female 19 45.2
      Age(yr)
      ≤55 26 61.9
      >55 Median(range) 16 52(23-71) 38.1
      Smoking history
      Yes 13 31.0
      No 29 69.0
      Stage
      Ⅰ stage 10 23.8
      Ⅱ stage 3 7.1
      Ⅲ stage 24 57.1
      Ⅳ stage 5 11.9
      Tumor location
      Center type 12 28.6
      Peripheral type 30 71.4
      Histology
      Adenocarcinoma 39 92.9
      Squamous cell carcinoma 0 0
      Adenosquamous carcinoma 1 2.4
      Others 2 4.8
      Differentiation degree
      Well differentiated 0 0
      Moderately differentiated 26 61.9
      Poorly differentiated 16 38.1
      Tab 2 Relationship between clinical characteristics and DFS, OS
      Group DFS(month) P OS(month) P
      Gender
      Male 14.7 0.117 26.2 0.630
      Female 18.8 32.8
      Age(yr)
      ≤55 19.1 0.257 32.0 0.652
      >55 17.4 30.0
      Stage
      Ⅰ+Ⅱ stage 30.3 0.016 55.5 0.025
      Ⅲ+Ⅳ stage 12.8 26.2
      Tumor location
      Center type 7.3 0.000 20.9 0.003
      Peripheral type 27.4 39.2
      Smoking history
      Yes 7.0 0.167 22.9 0.524
      No 17.4 32.8
      Differentiation degree
      Moderately differentiated 27.0 0.048 39.2 0.055
      Poorly differentiated 11.9 26.2
      Tumor diameter
      >3cm 12.8 0.200 32.0 0.502
      ≤3cm 27.0 33.4
      Lymph node metastasis
      Yes 12.8 0.027 27.8 0.071
      No 30.0 45.0
      adjuvant treatment
      Yes 19.1 0.000 33.4 0.001
      No 1.8 15.7


      Conclusion:
      EML4-ALK positive, postoperative NSCLC patients have distinctive clinical characteristics. The most common location of extrapulmonary metastasis was brain. DFS was associated with TNM stage, tumor location, differentiation degree, lymph node metastasis and adjuvant therapy. OS was related to TNM stage, tumor location and adjuvant therapy.

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