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P2.06 - Poster Session/ Screening and Early Detection (ID 219)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.06-026 - Advanced Bronchoscopies for Diagnosing Precancerous or Cancerous Lesions: A Meta-Analysis (ID 2694)
09:30 - 09:30 | Author(s): Q. He
- Abstract
Background:
Conventional white light bronchoscopy (WLB) has been used for decades. Some technical advances in bronchoscopies are available for detecting lung precancerous and cancerous lesions currently. Our aim was to investigate the performance of autofluorescence bronchoscopy (AFB), AFB combined with white light bronchoscopy (AFB+WLB), narrow-band imaging bronchoscopy (NBI) and, additionally, to directly compare these new techniques with WLB alone.
Methods:
Pubmed, Embase, Web of Science, Ovid, ProQuest, Scopus and the Cochrane Library were searched for relevant articles. Eligible studies should study any of the new techniques with histopathology as a golden standard, and should have sufficient data to construct 2×2 contingency tables. We used random-effects bivariate models to pool sensitivity, specificity, diagnostic odds ratio (DOR) and the area under the receiver operating curve (AUC) with 95% confidence interval.
Results:
Fifty-three studies involving a total of 6543 patients and 18458 biopsy specimens were included. Single arm synthesis of the new techniques showed that the overall sensitivity of AFB, AFB+WLB, NBI and WLB was 87% (82%-90%), 88% (82%-93%), 96% (78%-99%) and 54% (46%-61%); overall specificity was 65% (58%-72%), 59% (48%-68%), 84% (70%-92%) and 79% (73%-84%); and AUC was 85% (81%-87%), 82% (78%-85%), 94% (91%-96%) and 72% (68%-76%) respectively. In direct comparison, AFB, AFB+WLB and NBI had higher overall sensitivity, DOR and AUC, but lower specificity than WLB alone, regardless of precancerous or cancerous lesions (see in Table 1). In exploratory subgroup analysis, the sensitivities of all techniques were relatively higher in studies with higher proportion of elder patients, or in those with higher proportion of ‘high risk’ patients who had prior/suspected lung cancer or head & neck cancer. Figure 1
Conclusion:
Based on this pooled analysis, the performance of AFB, AFB+WLB or NBI is superior to WLB alone for diagnosing both lung precancerous and cancerous lesions. Its application might be preferably encouraged in populations with higher risk for non-benign lesions.
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P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.03-014 - The Impact of Post-Operative Adjuvant Chemotherapy for Resected NSCLC in the Real-World Setting: Single Center Experience (ID 2905)
09:30 - 09:30 | Author(s): Q. He
- Abstract
Background:
Recent evidence argues against the benefits from adjuvant chemotherapy (ad-chemo) for resected NSCLC in the real world setting. We sought to examine the impact of ad-chemo based on the data from our center.
Methods:
A consecutive cohort of 681 patients who underwent radical resection for stage I to III NSCLC in our center between Sep 2009 and Dec 2011 was collected. Patients who received adjuvant EGFR-TKIs were excluded. Patients lost follow-up upon discharge (uncertain history of ad-chemo) were included in sensitivity analyses. The primary endpoint was disease-free survival (DFS).
Results:
372 patients received ad-chemo whereas 224 did not, and the remaining 85 had no certain record of ad-chemo. There were 222 events (175 recurrence and 47 deaths). Univariate analysis showed that patients who received ad-chemo had shorter DFS than those who did not (HR 1.94, 95%CI 1.40 to 2.67; P<0.001). Incorporation of those without certain record of ad-chemo (HR 1.88; P<0.001) or excluding patients with stage I disease (HR 1.36; P=0.17) did not alter the trend. After adjusting for some important prognostic factors, such as stage, histology, visceral-pleural invasion, the inferiority of ad-chemo remained. In ad-chemo arm, we observed potentially better DFS in patients receiving platinum-based regimen (HR 0.64, 95% CI 0.38 to 1.07; P=0.09) and patients complete 4 or more cycles of ad-chemo (HR 0.73, 95% CI 0.52 to 1.01; P=0.05).
Conclusion:
Current results suggested that applying adjuvant chemotherapy should be based on strict patient selection. Establishment of selection criteria regarding recurrence risk and physical status is highly encouraged.
