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J.K. Park



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    P1.12 - Poster Session 1 - NSCLC Early Stage (ID 203)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.12-013 - Limited resection for solid non small cell lung cancers provides worse outcome despite of clinical early stage. (ID 2137)

      09:30 - 09:30  |  Author(s): J.K. Park

      • Abstract

      Background
      In recent years, Limited resection for ground glass opacity lesions is not inferior to lobectomy. However, the effect of limited resection on solid type early lung cancer is controversial. The aim of this study was to compare clinical outcomes of patients with solid type early stage non small cell lung cancer undergoing limited resection or lobectomy.

      Methods
      This is a retrospective study between March 2000 and September 2010. the patients with ground glass opacity lesion were excluded. Medical records of 164 patients with clinical stage IA were reviewed. 31 patients underwent limited resection and 133 patients underwent Lobectomy Disease free survival and overall survival were estimated by Kaplan Meier methods Prognostic factors associated with disease free survival and overall survival were analyzed by the Cox proportional hazards model.

      Results
      Limited resection group had medical comobidities significantly including old age (p<0.001), cardiovascular disease (p=0.001) and lower diffusing capacity of the lung for carbon monoide (p<0.001). The lobectomy was associated with longer disease free survival and overall survival (p=0.001) By multivariate analysis, Sublobar resection (p=0.011), lymphatic vessel invasion (p=0.006), and number of positive lymph nodes (p=0.028) were predictors for survival. Sublobar resection (p<0.001), visceral pleural invasion (p=0.002), and lymphatic vessel invasion (p<0.001) were predictors for disease-free interval.

      Conclusion
      Solid-type lung cancers demonstrated aggressive behavior and there were numerous significant pathologic prognostic factors in clinical stage IA NSCLC from our study. Lymph node metastasis was not rare in clinical stage IA NSCLC with a solid component. Lobectomy with lymph node dissection remains the standard surgical procedure for patients with solid-type clinical stage IA NSCLC.

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    P3.10 - Poster Session 3 - Chemotherapy (ID 210)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P3.10-025 - Taxane-Platinum Induction Chemotherapy in Locoregionally Advanced Non-Small-Cell Lung Cancer: Outcomes and Prognostic Factors (ID 1546)

      09:30 - 09:30  |  Author(s): J.K. Park

      • Abstract

      Background
      Induction chemotherapy (IC) in locoregionally advanced non-small-cell lung cancer (LA-NSCLC) has shown survival benefit. This retrospective study aimed to assess clinical outcomes and to identify prognostic factors in the LA-NSCLC patients who received taxane-platinum IC (TP-IC).

      Methods
      We reviewed medical charts, imaging studies, and pathologic reports in 51 LA-NSCLC pts who were treated with TP-IC between January 2003 and June 2012 at Seoul St. Mary’s Hospital and St. Vincent’s Hospital.

      Results
      Mean age at diagnosis was 63.1 years (range, 43-77). Forty-two pts (82.4%) were male. ECOG performance status was 0 in 17 pts (33.3%) and 1 in 34 (66.7%). Histology was squamous cell in 30 pts (58.8%), adenocarcinoma in 20 (39.2%), and large cell in 1. Thirty-four pts (66.7%) had stage IIIA disease, 13 (25.5%) IIIB and 4 (7.8%) IIB. All pts were treated with docetaxel 75 mg/m[2] or paclitaxel 175 mg/m[2], and cisplatin 75 mg/m[2] or carboplatin AUC 5 on day 1 every 3 weeks. Forty-four pts (86.3%) received docetaxel-cisplatin IC, 4 (7.8%) docetaxel-carboplatin, and 3 (15.7%) paclitaxel-cisplatin. The median number of IC cycles was 3 (range, 2-4). Mean relative dose intensity was 90.4% (±10.8) and RDI ≥90% was achieved in 31 pts (60.8%). During TP-IC, asthenia (88.1%), anorexia (89.1%), neutropenia (84.4%), alopecia (80.4%), nausea (71.7%) and myalgia (57.1%) were frequent. Most common grade 3/4 toxicity was neutropenia (80%) and febrile neutropenia occurred in 3 pts (5.9%). All toxicities were manageable with supportive care with no treatment-related death. Tumor response was assessed according to the RECIST and PERCIST criteria. According to RECIST, 3 pts (5.9%) achieved complete responses (CR), 32 (62.7%) partial responses (PR), 14 (27.5%) stable diseases (SD), and 2 (3.9%) progressive disease (PD). In addition, response evaluation by PERCIST was available in 38 pts, 5 pts (13.2%) achieved CR, 26 (68.4%) PR, 5 (13.2%) SD, and 2 (5.3%) PD. Thirty-one pts (60.8%) underwent surgery, 12 (23.5%) concurrent chemo-radiation (CCRT), 2 (4.3%) radiotherapy alone, 5 (9.8%) 2[nd] line chemotherapy or best supportive care and 1 lost follow-up. In 31 pts undergone surgical resection, 27 (87.1%) achieved R0 resection while 30-day postoperative death was reported in 2 pts. Median relapse-free survival (RFS) and overall survival (OS) were 10.7 months (95% CI, 8.1-13.2 months) and 25.5 months (95% CI, 20.4-30.6 months), respectively. The pts. with MD histology and objective metabolic response (CR+PR) by PERCIST showed significant longer RFS with HR of 6.27 (P=.002) and 3.23 (P=.04), respectively.

      Conclusion
      The TP-IC in LA-NSCLC showed remarkable tumor regression activity, leading to high R0 resection rate. MD histology and tumor response (CR+PR) by PET (PERCIST) were significant prognostic factors for RFS. Further study is ongoing to identify molecular markers affecting clinical outcomes.