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E.Q. Wu
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MINI 32 - Topics in Localized Lung Cancer (ID 166)
- Event: WCLC 2015
- Type: Mini Oral
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:D. Boffa, T. D'Amico
- Coordinates: 9/09/2015, 18:30 - 20:00, 201+203
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MINI32.02 - Characteristics of Non-Small Cell Lung Cancer (NSCLC) Patients Who Underwent Curative-Intent Surgical Resections in China (ID 1501)
18:35 - 18:40 | Author(s): E.Q. Wu
- Abstract
- Presentation
Background:
Lung cancer has been the leading cause of cancer related mortality for the past decades worldwide and in China. Non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases. For patients with early stage NSCLC, surgical resection is the mainstay of the treatment. This study aimed to better understand characteristics of NSCLC patients who underwent curative-intent lung surgical resections in China.
Methods:
Data were obtained from the NSCLC surgical outcome registry, which included 3,464 NSCLC patients who underwent curative-intent surgical resections from 13 tertiary hospitals in 11 provinces in 2013 and 2014. The registry documented detailed information on demographics as well as perioperative parameters.
Results:
The median age at the time of surgery was 60 (range 14 to 92) years, and 64.0% of the patients were male. Approximately 49.1% had a smoking history and 12.6% had a family history of cancer. About 45.7% patients had at least one comorbidity. The most prevalent comorbidities were cardiovascular disease, metabolic disease, respiratory disease, and other tumor, which affected 45.2%, 15.5%, 13.3% and 9.7% of the patients, respectively. The pulmonary function test showed a mean FEV1 of 2.33 (SD=0.63, range 0.32 to 4.81) L and FEV1/FVC of 79.3% (SD=12.6%, range 0.5% to 100.0%). The types of resection were lobectomies (lobectomies, bi-lobectomies and sleeve lobectomies) 79.3%, sublobar resections (segmentectomies and wedge resection) 8.5%, pneumonectomies 7.0%, and others 4.3%. 44.5% resections were performed by video-assisted thoracoscopic surgery (VATS). Adenocarcinoma and squamous cell carcinoma were the most common types of NSCLC, accounting for 60.2% and 31.4% of the patients, respectively. The most common tumor locations were right upper lobe (26.9%), left upper lobe (22.8%), right lower lobe (19.4%), left lower lobe (16.5%), and right middle lobe (6.5%). Pathologic staging showed 48.5% patients had stage I tumor; stage II, III, and IV accounted for 23.0%, 25.3% and 3.3%.
Conclusion:
The NSCLC patients who underwent curative-intent lung resection surgeries in China were relatively young and had good lung function. Adenocarcinoma and squamous cell carcinoma were the most common types. Nearly half of the procedures were performed by VATS and almost one out of two patients had pathologic stage I disease.
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P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.01-020 - Symptoms of Bone and Liver Metastases in Patients with ALK+ Non-Small Cell Lung Cancer (NSCLC) (ID 857)
09:30 - 09:30 | Author(s): E.Q. Wu
- Abstract
Background:
Among patients with ALK+ NSCLC who develop metastases, common metastatic sites include brain, bones, and liver. Although the symptomatic profile of ALK+ NSCLC patients with brain metastases is well documented, information remains limited for patients with bone metastases or liver metastases.
Methods:
Data from 2 large US administrative claims databases—IMS LifeLink Health Plan Claims (01/2001 – 03/2014) and Truven Health Analytics MarketScan (01/2002 – 09/2012)—were pooled for this retrospective study. Among adult patients with a lung cancer diagnosis, ALK+ NSCLC patients were identified based on prescription fills for crizotinib. Patients were analyzed if they had ≥60 days of follow-up before and ≥30 days after the bone metastasis or liver metastasis diagnosis date.
Results:
A total of 231 ALK+ NSCLC patients were selected: 191 had bone metastasis and 104 had liver metastasis. For the bone metastasis sample, median age was 54.9 years, 39.3% were male, and median time from first lung cancer diagnosis to the bone metastasis diagnosis was 30 days. The frequency of symptoms frequently associated with bone metastasis increased after bone metastasis diagnosis compared to before. Common skeletal-related events included pathologic fractures (before: 0.5% vs. after: 12.6%), spinal cord compression (2.6% vs. 5.2%), and bone radiation therapy (12.6% vs. 62.3%).Other common symptoms were weakness/fatigue (before: 24.6% vs. after: 46.6%), anemia (10.5% vs. 33.0%), back pain (8.4% vs. 22.5%), bowel dysfunction (6.8% vs. 20.9%), and neoplasm-related pain (0.0% vs. 14.1%). For the liver metastasis sample, median age was 54.0 years, 42.3% were male, and median time from first lung cancer diagnosis to first liver metastasis diagnosis was 151 days. The frequency of symptoms frequently associated with liver metastasis also increased compared to before liver metastasis diagnosis, where most common symptoms were nausea/vomiting (before: 21.2% vs. after: 42.3%), abdominal pain (20.2% vs. 34.6%), fever/sweating (6.7% vs. 27.9%), edema (6.7% vs. 25.0%), jaundice (0.0% vs. 3.8%), and fatigue (29.8% vs. 46.2%).
Conclusion:
ALK+ NSCLC patients experience an increased symptomatic burden after developing bone metastasis or liver metastasis. Further research is warranted to analyze the impact of the symptomatic burden on patient quality of life and other outcomes as well as the potential benefit of instituting second-generation ALK-inhibitors earlier in the treatment course.
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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
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-031 - Patient Outcomes following Curative-Intent Lung Resection among Non-Small Cell Lung Cancer (NSCLC) Patients in China (ID 2559)
09:30 - 09:30 | Author(s): E.Q. Wu
- Abstract
Background:
Lung resection is a common treatment for patients with non-small cell lung cancer (NSCLC), particularly those with early stage disease. This study aimed to assess patient short-term outcomes following curative-intent lung resection among patients with NSCLC.
Methods:
Data were obtained from an NSCLC surgical outcome registry, which included patients from 13 tertiary hospitals in 11 provinces in 2013 and 2014. The surgery types include thoracotomy, video-assisted thoracic surgery (VATS), conversion from thoracotomy to VATS and mini-thoracotomy under VATS. Among all patients, 1,071 were followed up for at least 6 months. Post-surgery treatment pattern and patient outcomes (surgical complication rate and rates of survival, new metastasis and recurrent at the 6-month follow-up) were described; patient outcomes were compared among different tumor stages using Fisher’s exact test.
Results:
Among the 1,071 patients with ≥ 6-month follow up, the median age was 60 (range 26 to 84) years old and 68.3% were male. The most common types of cancer were adenocarcinoma (56.1%) and squamous cell carcinoma (38.3%). Based on the pathologic staging, 42.3% patients had stage I tumor; and stage II, III and IV tumor accounted for 27.5%, 27.8% and 2.4% of the patients, respectively. After surgery, 57.9% patients received further treatment: most of them received chemotherapy (78.3%), 1.2% received targeted therapy, 1.2% received radiation, 0.3% received re-operation, 7.2% received alternative medicine treatment. The overall post-surgery complication rate following surgeries was 6.0% and it did not vary significantly by stage (5.1%, 5.4%, 9.4% and 9.5% for stage I-IV, respectively; p=0.122). The overall survival rate at 6 months was 96.2% and it decreased substantially with increasing stage (98.3%, 95.4%, 92.2% and 85.7% for stage I-IV, respectively; p=0.0005). Recurrence rate was 1.5% for all patients and it was substantially higher among patients with stage IV cancer (2.2 %, 1.7%, 0.4% and 10.0% for stage I-IV, respectively; p=0.032). New metastasis occurred in 6.4% patients. Again, the rate varied significantly across different stages (4.9%, 4.2%, 10.0% and 25.0% for stage I-IV, respectively; p=0.001).
Conclusion:
Chemotherapy was the most commonly used treatment after surgery for NSCLC patients. Additionally, the NSCLC patients who underwent curative-intent lung resection surgeries had relatively high survival rate, low rates of recurrence and new metastasis at the 6-month follow up. As expected, prognosis became worse with increasing tumor stage.
