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T. Murakawa
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-002 - Impact of Multiple Cancer Treatment History on Outcome in Patients with Surgically Resected Non-Small Cell Lung Cancer (ID 841)
09:30 - 09:30 | Author(s): T. Murakawa
- Abstract
Background:
It has been common that patients with previous cancer treatment history undergo curative resection of non-small cell lung cancer (NSCLC); however, the impact of multiple cancer history on outcome after surgery remains unclear.
Methods:
We conducted a retrospective study by using data from patients who underwent curative surgical resection for NSCLC between 1998 and 2011 at our institution. Data recorded for analyses were: age, gender, clinical and pathological stages of NSCLC, mode of surgical resection, comorbidities, pre-treatment serum CEA level, smoking history, and previous cancer history (organ, histologic type, number of cancer treated). The chi-square test and Wilcoxon test were used to analyze the factors between groups (ie, cases with previous cancer history versus those without cancer history). The Kaplan-Meier method was used to estimate survival rates. The log-rank test was applied to compare the survival rates between the groups. A p value less than 0.05 was considered as statistically significant.
Results:
In the study, 229 out of 923 cases (24.8%) had previous cancer treatment history. In the 229 cases, 194 had single cancer treatment history, 30 had double cancer treatment history, and 5 had triple cancer treatment history. Types of cancer treated were: colorectal cancer (n=51), lung cancer (n=30), hepatocellular carcinoma (n=25), breast cancer (n=16), esophageal cancer (n=15), renal cell cancer (n=12), cancers of head and neck (n=11), and others (n=56). There were significantly increased rate of having cancer treatment history in the later study period (2005-2011) compared to a rate in the earlier study period (1998-2004)(30% versus 15%, p<0.01). When comparing to patients without previous cancer history, those with previous cancer history were significantly older (69.1 versus 66.4 years, p<0.01), and had higher smoking history rate (75.1% versus 64.7%, p<0.01). On the other hand, the proportion of stage I NSCLC was significantly higher in cases with previous cancer history than those without previous cancer history (95.2% versus 74.4%, p<0.01). All cases with triple cancer treatment history had clinical and pathological stage I NSCLCs. The survival outcome after surgical resection was significantly better in cases without previous cancer treatment history than those with cancer treatment history (5-year survival rates; 79% versus 75%). In those with cancer treatment history, cases with 2 or more cancers treated had worse outcome than those with only one cancer treated before lung cancer resection (5-year survival rates; 69% versus 76%).
Conclusion:
Although the previous cancer treatment history and the number of cancers treated affected the outcome of patients who underwent curative lung cancer resection, the 5-year survival rate of 75% was achieved in the population. In those with previous cancer history, lung cancer tends to be found in early stage because of the periodical check-up for previous cancers. Therefore, surgical resection of newly detected NSCLC can be a viable option, if the previously treated cancer(s) are well controlled and the new lung cancer is deemed resectable.
