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A.M. Sedef
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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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P3.03-037 - High Pretreatment Neutrophil-Lymphocyte Ratio: A Poor Prognostic Factor for Stage III Non-Small Cell Lung Cancer Patients (ID 1034)
09:30 - 09:30 | Author(s): A.M. Sedef
- Abstract
Background:
Smoldering inflammation induced by tumor tissue form cytokine enrich environment which increase tumor growth potential significantly. Neutrophil-Lymphocyte ratio (N/L) has been reported as a valuable indicator for tumor induced systemic inflammation in literature. With this study, we aimed to evaluate potential prognostic role of pretreatment N/L ratio in locally advanced NSCLC patients those who were treated with curative chemoradiotherapy.
Methods:
Stage III 97 NSCLC patients were included into this study. Demographic characteristics of patients and well defined clinic and histopathological prognostic factors of their tumors were recorded. There is no clear delineated cut off value for N/L ratio in literature; first, we performed ROC curve statistical analysis. Our statistical analysis showed cut off level of 4.26 ED with high sensitivity and specifity. We used Kaplan-Meier survival curve and log-rank test (p<0.05) for survival analysis.
Results:
Figure 1 Median age was 58 years old (range 39-75), and 87 (89.7%) of the patients were men. ECOG performance score was 0-1 in 93 patients (95.9%). Squamous histology, most common histology, was diagnosed in 46 patients (47.4%). Number of Stage IIIA and IIIB patients 41(42.3%) and were 56 (57.7%), respectively. Objective response rate (CR+PR) and clinical benefit rate (CR+PR+SD) were 75.3% and 83.5%, respectively. Median follow-up time was 23.8 months (range 0.9-60). Median PFS and OS were 10.3 ([(95%CIs), 9.2-11.5) and 17.8 months ([(95%CIs), 11.4-24.4]. When we evaluate 61 (62.8%) patients those who relapsed, distant and local relapse rate were found as 57.1 and 42.9 %, respectively. When the patients were grouped through N/L ratio, below (group a) or upper (group b) the cut-off value (4.26 ED), there was a statistically significant difference between these groups, group a and group b, PFS and OS; 15.2 vs 8.1, 34 vs 23 months, respectively (p<0.005).
Conclusion:
Prognostic and predictive markers are major tools for oncologist to make decision making process. With this study, our results proved that pretreatment N/L ratio, marker for the systemic inflammation, may be used as a prognostic marker for the local advanced stage III NSCLC patients.
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P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.04-116 - Prognostic Role of fox-p3 Positive T-Regulatory Cells in Curatively Resected NSCLC Other than Stage IA (ID 2387)
09:30 - 09:30 | Author(s): A.M. Sedef
- Abstract
Background:
Curative surgical excision accompanied by adjuvan chemotherapy for those stage II, III and high risk stage IB patients for completely resected early stage Non-small cell lung cancer is the widely accepted. However, over 50 % of cases in this early stage group recur and die after this aggressive treatment strategy. Currently used prognostic markers are imperfect to estimate the patients with high risk of relapse. Biologic agents which increase the immune system activity recently approved in the treatment of advanced NSCLC. Main aim of this study is to explore the prognostic role T-regulatory cells, which has essential role in decreasing effect of cytotoxic cells on tumor tissue, in early stage NSCLC.
Methods:
A total 48 patients those who were resected with R0 resection in baskent university between 2005-2009. Stage IA patients were excluded. İmmunohistochemical staining made on the parffin embedded tissue. Kaplan meier survival curve and log-rank test used for the stattistical evaluation. The values of p below the <0.05 was accepted as statistical signifcant.
Results:
A total 48 patients, 40 (83.3%) male and 8 (16.7%) female, were included. ECOG 0, 1, 2 scale were found in 32(66.7%), 14(29.2%), and 2 (4.2%) patients, accordingly. Mean follow-up time for whole group was 49 months (6-128). Adjuvant chemotherapy were given to 16 patients (33.3%) at physician discretion. There were 21(43.8%), 14(29.2%), and 13 (27.2%) patients with stage of IB, II, and III, respectively. Grade 0, 1, 2, 3 IHC staining intensity for CD 3 and FOX-P3 were found in 0-25 (52.1%), 11(22.9%)-21(43.8%), 16(33.3%)-2(4.2%), and 21(43.8%)-0 patients, respectively. We build a risk score based on the rate of FOXP3/CD3 grades. Low risk, intermediate risk, and high risk score were detected in 22 (45.8%), 17 (35.4%), and 9 (18.8%) patients, respectively. Disease relapse rate were 88.9, 76.5, and 18.8% in high, intermediate, and low risk group. (p:0.005). Disease free survival and overall survival were 30 (14.7-45.6) and 49 months (20.6-77.7). In univariate analyses, ECOG performance (p=0.025) scale, pathological stage (p=0.029), and grade of FOX-P3 (p=0,032) had statistically significant effects on disease free survival (DFS). In univariate analyses, ECOG performance (p=0.008) scale, pathological stage (p=0.03), and IHC staining intensity of FOX-P3 (p=0,018) had statistically significant effects on overall survival (OS). The statistical analysis failed to show statistically significant effects of formed risk groups (p>0.005) on DFS and OS.
Conclusion:
In conclusion, results of the present study showed that increase the IHC staining of T-reg cells in tumor tissue significantly related with tumor relapse (higher the intensity-higher the relapse rate). Univariate analysis showed that IHC staining intensity had negative prognostic factor and statistically significant effect on both DFS and OS.
