Author of

• 10743

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  P1.10 - Poster Session 1 - Chemotherapy (ID 204)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10788

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    P1.10-045 - Validation Study of Postoperative Platinum-based Adjuvant Chemotherapy for Japanese Patients with Completely Resected Pathological StageIIIA Non-small Cell Lung Cancer (ID 2608)

    09:30 - 09:30  |  Author(s): M. Naito
    • Abstract

    Background
    In the Japanese Clinical Practice Guideline for Lung Cancer, postoperative platinum-based adjuvant chemotherapy in patients with pathological stage IIIA (p-stage IIIA) non-small cell lung cancer (NSCLC) is recommended (grade B). However, the verification of the effect of adjuvant chemotherapy in Japanese patients is not sufficient. In this study, we aimed to validate the effectiveness of platinum-based adjuvant chemotherapy for p-stage IIIA NCSLC.

    Methods
    Between January 2002 and December 2009, we retrospectively reviewed records of patients with completely resected p-stage IIIA NSCLC in our institution. Exclusion criteria include the patients with oral anticancer drug, tegafur and uracil (UFT), >75 years old, large cell neuroendocrine carcinoma and pleomorphic carcinoma. The primary endpoint of this study was progression-free survival. Cumulative survival curves were estimated with the Kaplan-Meier method and compared with the log-rank test. Multivariable analysis was performed with the Cox proportional hazards regression model to estimate the independent prognostic effect of adjuvant chemotherapy on prognosis by adjusting for confounding factors.

    Results
    Sixty-seven patients (median age, 63 years; 40 men, 27 women) were eligible. 49 patients had adenocarcinoma and 18 had squamous cell carcinoma. 63 patients underwent lobectomy and 4 patients had pneumonectomy. Of the 33 patients with platinum-based adjuvant chemotherapy regimens, 16 had cisplatin plus gemcitabine, 13had carboplatin plus paclitaxel, and 4 had cisplatin plus vinorelbine. Five-year progression-free survival (PFS) and 5-year overall survival (OS) in the adjuvant chemotherapy group versus in surgery alone group were not statistically significant (5-year PFS rates were 28% and 31%, respectively; p = 0.69, and 5-year OS rates were 54% and 40%, respectively; p = 0.10). Multivariate analysis showed that platinum-based adjuvant chemotherapy did not affect patient prognosis significantly (HR, 0.70; 95% CI, 0.37-1.32; p=0.27).

    Conclusion
    Our date showed that platinum-based adjuvant chemotherapy in patients with p-stage IIIA NSCLC did not have such impact on our patient’s prognosis as we could understand in daily medical practice. Although there were some limitations of this study, we feel a strong need for searching more effective chemotherapy regimens or individualized treatment strategies.

• 12701

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  P3.12 - Poster Session 3 - NSCLC Early Stage (ID 206)

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

  • 12711

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    P3.12-010 - Impact of parietal pleural invasion at adhesion sites of lung cancers and implications for prognosis in the 7th TNM classification (ID 2160)

    09:30 - 09:30  |  Author(s): M. Naito
    • Abstract

    Background
    In the 7th tumor, node, metastasis (TNM) classification or lung tumors, visceral pleural invasion (VPI) of lung cancers is defined as invasion beyond the elastic layer, including invasion to the visceral pleural surface, and T1 tumors with VPI are upgraded to T2a. Recently, we demonstrated that the microscopic invasion beyond elastic fibers of the visceral pleura but no penetration to the parietal pleura at tight adhesion sites (we term this p1-3) should be managed as a T2 disease in the 6th edition (Virchows Arch. 2005; 447: 984-9). Thus, this study investigated the prognostic value of p1-3 invasion in the current 7th TNM classification.

    Methods
    Between 2000 and 2012, 976 consecutive patients with non-small cell lung cancers (NSCLCs) underwent curative surgical resection at the Kitasato University Hospital. Staging definitions for T, N, and M components were according to the 7th International Staging System for Lung Cancer. Twenty two patients (2.3%) with p1–3 pleural invasion were included. These patients were studied clinically and pathologically in comparison with cases treated during the same period. To maximize the power of assessing prognostic potential, we set the significance level at 0.10, one-sided.

    Results
    The p1–3 condition sites of the 22 cases were the parietal pleura for all cases. The 5-year overall survival (OS) rate for these p1–3 patients was 62%. No significant differences were observed among p1–3, IB, IIA or IIB groups (p=0.185). However, the 5-year OS curve of p1-3 and N0 group (n=15) was similar to that of N0 and IIB disease.

    Conclusion
    Our results indicate that p1–3 patients can be managed as having a T3 (PL3) disease for the present classification, and that in such cases, complete tumor removal could improve the long-term survival. Because of the small number of patients available for this analysis, a large-scale and nationwide study is warranted for validation of p1–3 status as a T3 (PL3) disease for NSCLCs.