Author of

• 11001

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  P1.24 - Poster Session 1 - Clinical Care (ID 146)

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

  • 11044

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    P1.24-043 - Results of a Multidisciplinary Team in the Management of Non-Small Cell Lung Cancer in a Developing Country (ID 3041)

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

    Background
    Lung cancer has the highest cancer-related mortality in the World. In developing countries, mortality rates tend to be higher due to deficits of diagnostic and professional resources, and long time intervals between patient’s symptoms and the initiation of treatment. Multidisciplinary teams improve the care of patients with NSCLC, but this practice is not common in developing countries. In Costa Rica more than 90% of cancer patients are treated in a public hospital where resources are limited. To improve patient care a weekly multidisciplinary thoracic oncology meeting was organized in Hospital San Juan de Dios, one of Costa Rica’s three adult general hospitals. This hospital is responsible for the management of more than 40% of Costa Rica’s cancer patients.

    Methods
    A multidisciplinary team including Medical Oncology, Pneumology, Pathology, Thoracic Surgery, Radiology and Radiation Oncology started to meet in a weekly basis since November 2011. All patients with a possible lung cancer in the hospital were evaluated by the team and recommendations were given. Data of patients with NSCLC seen by the multidisciplinary team during 2012 was compared to a historic data of NSCLC patients diagnosed in the same hospital between 2003 and 2008 when there was no multidisciplinary team involved in patient care. Exclusion criteria included insufficient clinical information. Epidemiologic data was analyzed and survival curves were obtained.

    Results
    In the periods 2003-2008 and 2012, 92 and 39 patients respectively with NSCLC were included for analysis. Epidemiologic results are summarized in Table 1 and overall survival is plotted in Figure 1. Figure 1 Figure 2

    Conclusion
    The inclusion of a multidisciplinary team in the management of NSCLC lead to an earlier diagnosis and increased survival of patients. This approach should be considered in the management of NSCLC patients in a developing country.

• 11917

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  P2.21 - Poster Session 2 - Diagnosis and Staging (ID 170)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11927

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    P2.21-010 - EGFR mutation frequency in patients diagnosed with NSCLC from Costa Rica (ID 3459)

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

    Background
    Histological differentiation in NSCLC has been addressed recently due to the importance regarding prognosis and treatment options. Adenocarcinoma is considered the most frequent histology and recent guidelines recommend the EGFR mutation testing. Epidemiological characteristics of EGFR mutation positive patients have been widely described in Caucasian and Asian population. Given the differences between these populations, it is important to evaluate the epidemiology in other populations. More than 90% of Costa Rica’s population is treated in a government-based hospital. Hospital San Juan de Dios (HSJD) attends approximately a 40% of Costa Rica’s population. Starting at the end of 2011, all patients with lung adenocarcinoma are evaluated for EGFR mutations.

    Methods
    We conducted a retrospective analysis of all patients diagnosed with NSCLC in HSJD between January and December 2012. A total of 42 patients were diagnosed with a NSCLC but 2 patients were excluded from the study due to insufficient clinical information. Epidemiologic data was obtained and EGFR mutation status was analyzed.

    Results
    The NSCLC population analyzed had a median age of 68 y (41-87 y). The most frequent histology reported was adenocarcinoma. All adenocarcinomas were analyzed for EGFR mutations (exon 18, 19, 20, and 21). 33.3% of adenocarcinoma patients had an EGFR mutation. Smoking history was statistically associated with the occurrence of an EGFR mutation. Patient characteristics are summarized in Table 1.

    Table 1: Characteristics of patients diagnosed with NSCLC in HSJD-Costa Rica during 2012 Total NSCLC population n=40 Adenocarcinoma population n=27 EGFR mut positive population n=9 Median age 68 y (41-87 y) Sex p=0.504 M (%) 24 (60) 15 (55.6) 4 (44.4) F (%) 16 (40) 12 (44.4) 5 (55.6) Smoking history (PY) p=0.022 Non smoker (%) 14 (35) 12 (44.4) 7 (77.8) 5-20 (%) 3 (7.5) 3 (11.1) 0 21-40 (%) 4 (10) 1 (3.7) 0 41-60 (%) 9 (22.5) 4 (14.8) 1 (11.1) >60 (%) 10 (25) 7 (26) 1 (11.1) Adenocarcinoma histology (%) 27 (67.5) Stage of diagnosis I-II 3 (7.5) 2 (7.4) 0 IIIA 9 (22.5) 4 (14.8) 0 IIIB 5 (12.5) 2 (7.4) 0 IV 23 (57.5) 19 (70.4) 9 (100) % EGFR mutation positive 22.5 33.3 % of type of EGFR mutation Exon 18 0 0 0 Exon 19 17.5 25.9 77.8 Exon 20 2.5 3.7 11.1 Exon 21 2.5 3.7 11.1

    Conclusion
    In Costa Rica, the incidence of EGFR mutations in adenocarcinoma patients tends to be higher to that of the Caucasian population and lower than the Asian population. This incidence might be similar in other Latin American countries. Epidemiological characteristics of EGFR mutation positive patients are similar to that reported in the literature.