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S. Jheon
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MINI 17 - WT EGFR, Angiogenesis and OMD (ID 131)
- Event: WCLC 2015
- Type: Mini Oral
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:R. Feld, R. Dziadziuszko
- Coordinates: 9/08/2015, 16:45 - 18:15, Mile High Ballroom 4a-4f
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MINI17.14 - Survival Analysis following Pulmonary Metastasectomy for Non-Small Cell Lung Cancer (ID 2523)
18:00 - 18:05 | Author(s): S. Jheon
- Abstract
Background:
The effectiveness of pulmonary metastasectomy for non-small cell lung cancer(NSCLC) is controversial. The aim of this study is to report the overall survival after pulmonary metastasectomy for NSCLC and to determine prognostic factors for survival.
Methods:
Between June 2003 and July 2007, 39 patients underwent pulmonary metastasectomy in single center. Data from first time of pulmonary metastasectomy were included and data from more than second time of pulmonary metastasectomy were excluded.
Results:
There were 24 men and 15 women, and the median age at pulmonary metastasectomy was 64.0 years. The median recurrence free time from initial pulmonary resection to pulmonary metastasectomy was 18.5 months. The overall 5-year survival rate was 67.2%. In univariate analysis, ager under 70 years, recurrence free time over 24 months, adenocarcinoma and normal CEA level were prognostic factors for overall survival. Gender, initial TNM stage, operation type of pulmonary metastasectomy, number and size of pulmonary nodule and distance from nodule to margin were not associated with overall survival.
Conclusion:
In selected patients, pulmonary metastasectomy for NSCLC may confer a good survival. It appears reasonable that such patients should be considered as surgical candidates.
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P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.03-024 - Comparison of Prognosis Between Patients with Solitary Lung Adenocarcinoma and With Multiple Primary Cancers Including Lung Adenocarcinoma (ID 2330)
09:30 - 09:30 | Author(s): S. Jheon
- Abstract
Background:
As advances in diagnostic tools and treatment methods, patients with multiple primary cancers are expected to increase. We investigated the prognosis of multiple primary cancer patients who underwent surgical management for lung adenocarcinoma, and compared it with that of patients who suffered from lung adenocarcinoma only.
Methods:
Medical records of lung adenocarcinoma patients who underwent surgical management in our institute between 2003 and 2012 were reviewed retrospectively. Patients with multiple primary lung cancer, either synchronous or metachronous, and patients underwent neoadjuvant therapy were excluded. We categorized enrolled patients into 2 categories; (1) Group 1; patients with lung adenocarcinoma only, (2) Group 2; patients with lung adenocarcinoma and other primary cancers. Clinicopathologic characteristics were compared between two groups, and survival analysis was done.
Results:
A total of 964 patents were enrolled in this study, and 17.7% have primary cancers other than lung adenocarcinoma (Group 1; 793, and Group 2; 171). Mean follow-up periods were 55.1 months (± 29.00, ranged from 0.0 to 139.2 months), and mean age at the time of surgery were 62.0 (± 10.51, ranged from 20 to 91). There were no significant differences in gender between two groups (p=0.400), however, the mean age of Group 2 was higher in Group 2 (p=0.005). The SUVmax value and tumor sizes were higher in Group 1 (p<0.000 and p<0.000 respectively). The presence of visceral pleural invasion, EGFR mutations and p53 showed no significance between two groups (p=0.322, p=0.728 and p=0.966 respectively). N stages were higher in Group 1 than group 2 (p=0.026). Overall 3-year and 5-year survival rates in Group 1 (87.0% and 80.6%) and Group 2 (89.1% and 80.6%) showed no statistically significant differences (p=0.926), Likewise, those of disease-free survival rates in two groups (71.1% and 66.5% in Group 1, 78.0% and 74.4% in Group 2) revealed no significant differences (p=0.054).
Conclusion:
Patients of lung adenocarcinoma with multiple primary cancers showed no prognostic inferiority, and the stages of lung cancers tended to be lower. Careful inspections for finding other malignancies in multiple primary cancer patients can contribute to reduce lung cancer mortality.
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P1.06 - Poster Session/ Screening and Early Detection (ID 218)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.06-028 - Distribution of Stage, Surgical Methods and Prognosis of Lung Adenocarcinoma According to the Initial Diagnostic Patterns (ID 2333)
09:30 - 09:30 | Author(s): S. Jheon
- Abstract
Background:
Early detection of lung adenocarcinoma is important for reducing cancer mortality. We investigated how lung adenocarcinoma has been diagnosed in our institute, and evaluate the effects on the treatment and prognosis.
Methods:
Medical records of 1065 patients who had undergone lung cancer treatment including surgery in our institute between 2003 and 2012 were reviewed retrospectively. We excluded patients who lacked data for diagnostic process (3 patients) and underwent neoadjuvant therapy (38 patients). Patients were categorized into 3 groups, (1) group1; patients who were diagnosed during routine medical examination, (2) group2; patients with symptoms, and (3) group3; patients who were diagnosed during the treatment of other diseases. Surgical methods, stages and diagnostic tools were compared and survival analysis was done.
Results:
A total of 1024 patients were included. The mean follow-up periods were 55.8 months (± 29.00, range from 0.00 to 139.20). The number of sublobal resection (wedge resection and segmentectomy) in group1, 2, and 3were 85, 37 and 89 respectively. Group1 and group3 underwent significantly more limited resection than group 2 (p<0.000). The number of VATS approaches were 341 (80.6%), 148 (52.7%) and 231 (70.3%) in group1, 2, and 3 respectively. Group2 and group3 had significantly more open thoracotomy than group1 (p<0.000 for group2 and p=0.042 for group3). Early stage lung adenocarcinoma (including 0, IA and IB) was found more in group1 (318 patients, 75.2%) and in group3 (251, 78.4%) than in group 2 (150, 53.4%). Overall and disease-free survival periods of group1 (57.0 ± 27.60 and 50.4 ± 30.89) and group3 (54.6 ± 27.67 and 46.9 ± 29.57) were significantly higher (p <0.000 and p=0.002 for overall survival, P<0.000 for disease-free survival) respectively than those of group2 (55.5 ± 32.38 and 42.6 ± 34.92). Group 1 and group3 has no significant differences both in overall and disease free survival periods. Chest computed tomography was most commonly used diagnostic tool in group2 and group3 (48.4% and 35.6% respectively), on the contrary, chest roentogram in group1.
Conclusion:
Incidentally found lung adenocarcinoma during treatment for other diseases has no differences with those in regular health examinations in stages, surgical extent and prognosis. Careful inspection for those patients could contribute equally for early detection of lung adenocarcinoma as routine screening.
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P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-037 - Prognostic Factors in Pathologic N2 Non-Small Cell Lung Cancer (ID 3193)
09:30 - 09:30 | Author(s): S. Jheon
- Abstract
Background:
Mediastinal lymph node metastasis is one of the strong prognostic factors in non-small cell lung cancer (NSCLC). Pathologic N2 patients group is heterogenous group consists of stage IIIA to stage IV. Moreover owing to difficulty in preoperative prediction of N2 disease, pathologic N2 patients group shows more variable in clinical stage. We tried to figure out which factors make difference in prognosis of N2 patients.
Methods:
Between May 2003 and December 2013, total 1994 patients underwent pulmonary resection surgery due to lung cancer. Only pathologically proven N2 patients were included in the study. Among them, patients with small cell lung cancer, double primary lung cancer and other malignant disease were excluded. Therefore, 195 N2 patients were analyzed for the study. The patients' clinical information was collected from prospectively recorded database and analyzed retrospectively. Regional N2 disease was defined as upper mediastinal LN involvement for upper lobar disease and lower mediastinal LN involvement for lower lobar disease. Extended N2 disease was defined as involvement of non-regional N2 station.
Results:
Figure 1Mean follow up duration was 41 months and 5 year survival rate was 50% for the study population. As postoperative stage, majority of the study group was IIIA (84%). Patients' clinical stage and clinical T stage did not make difference in survival and recurrence. However clinical N0 group showed superior result in survival (p<0.001) and recurrence (p=0.46) even in same stage. In metastatic mediastinal LN extent analysis, extended N2 disease made worse survival than regional N2 disease (p=0.04). Total number of metastatic LN did not make any difference in prognosis.
Conclusion:
Owing to heterogeneity, even in same stage group, pathologic N2 patients have showed different prognosis. In this study, we confirmed that clinical N0 was relatively good prognostic factor and extended N2 disease was bad prognostic factor. Deciding postoperative treatment plan, we should take account of these factors. Also, the survival difference between regional and extended N2 disease might be considered in staging revision of NSCLC.
