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P. Bergman
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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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P2.02-041 - Stereotactic Body Radiotherapy (SBRT) or Surgery in Early Stage (I & II) Non Small Cell Lung Cancer (NSCLC) (ID 1621)
09:30 - 09:30 | Author(s): P. Bergman
- Abstract
Background:
For patients with NSCLC clinical stages I and II disease with no medical contraindications, surgery is treatment of choice showing 5-year survival rates of about 60–80% for stage I and 40–50% for stage II, respectively. However, for patients who are medically or technically unfit for surgery and for patients refusing surgery, SBRT) is an alternative with local control rates >90% at 3 years.
Methods:
Medical journals in all patients with stage I or II NSCLC who were underwent surgery and treated with SBRT at the Department of oncology or thoracic surgery, Karolinska University Hospital, Sweden from 2003 to 2009 were retrospectively reviewed.
Results:
In all, 186 (78.2%) underwent surgery and 52 (21.8%) were treated with SBRT. Mean, median and range of age among the surgery group was 69.29, 70.52 and 45-85 years, while in the SBRT group, these figures were 78.04, 80.03 and 61-89 years. The difference in age between the groups was significant (p=0.03).There were significantly more comorbidites in the SBRT group. Among the surgery group, 91.3% were smokers or former smokers. The figures for SBRT group was 94.1%. There was a significant difference in performance status (PS) between the groups (p<0.001) with with PS 0-1 in 98.9% in the surgery group compared with 69.2% in the SBRT group. There was a significant difference in lung function with mean FEV1 2.15 liter in surgery group compared to 1.45 in the SBRT group. The figures for mean FEV1% was 83% respectively 57.5%. The median overall survival was 97 months for the surgery group and 61.8 months for the SBRT group (p<0.001).
Conclusion:
The much worse median overall survival in the SBRT group can be explained by the selection of patients, but still, a survival of more than 5 years in an elderly group with so many comorbidities and a bad PS indicates that SBRT has been of value.
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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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P3.02-019 - Surgery in Elderly Patients ( > 70 Years or Older) with Non-Small Lung Cancer (NSCLC). Impact of Adjuvant Chemotherapy (ID 2243)
09:30 - 09:30 | Author(s): P. Bergman
- Abstract
Background:
Surgery remains the cornerstone of therapy for medically operable patients with early stage NSCLC. Differences in the frequency of surgery for patients with respect to their age, sex and socioeconomic deprivation have been described. Older patients have been found to be less likely to undergo surgery compared with younger patients even when they have similar performance status. Several randomized trials and meta-analyses have shown that adjuvant chemotherapy after resection of stages II–IIIA NSCLC improves survival.
Methods:
The medical records of all 164 patients ≥70 years, who underwent surgery for NSCLC from 2003 to 2009 at our department, were reviewed retrospectively.
Results:
One-hundred twenty-six given no adjuvant therapy. Eigthy-seven (52.4%) were male. Median mean and range of age male patients was 75.0, 74.8 and 70-85 years, while in females, these figures were 74.0, 75.5 and 70-84 years. Eighty-one (94.2%) of the males and 65 (82.3%) of the females were smoker/former-smoker. In both sexes 99% had performance status 0-1. Eighty-one (93.1%) of male patients and 71 (89.9%) of the females were stage I-II. Adenocarcinoma was the common histology in both sexes (55% of the males and 67.1% of the females). Squamous cell carcinoma came in second place, 31% respectively 20%. Lobectomi performed in 61 (84.1%) of the male patients and 62 (86.2%) female patients, left pneumonectomy in 6 (7.3%) male patients and 5 (6.9%) in female patients, right pneumonectomy in 1(1.4%) female patient. One-hundred twenty-six (77%) did not receive adjuvant therapy, mainly because of age. Median overall survival among all was 7.2 years, in the non-adjuvant group was 6.7 years and 7.6 years in the adjuvant group (p=0.5712).
Conclusion:
This single-institution series demonstrates that surgical intervention for appropriately selected elderly patients with NSCLC results in improved overall survival. Surgery should, therefore, be strongly considered for select patients ≥ 70 years of age with stage I/II and select stage IIIA NSCLC who have adequate pulmonary reserve.
