Virtual Library
Start Your Search
J.P. Franceschini
Author of
-
+
MA01 - Improvement and Implementation of Lung Cancer Screening (ID 368)
- Event: WCLC 2016
- Type: Mini Oral Session
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:M. Studnicka, C. Berg
- Coordinates: 12/05/2016, 11:00 - 12:30, Lehar 1-2
-
+
MA01.10 - Performance of ACR Lung-RADS in the 1st Brazilian Lung Cancer Screening Trial (BRELT1) (ID 6156)
12:00 - 12:06 | Author(s): J.P. Franceschini
- Abstract
- Presentation
Background:
In BRELT1 we found a significant number of low dose CT (LDCT) considered positive (nodules > 4mm). The aim of this study was to assess the effect of applying ACR Lung-RADS and Pre-Test Probability of Malignancy (PTPM) in suspicious nodules > 8mm founded in a clinical CT lung screening program.
Methods:
Clinical LDCT (baseline and follow up) containing nodules > 8mm were retroactively reclassified using the new ACR Lung-RADS™ structured reporting system and PTPM. The model used in this study to predict the probability of malignancy was designed by Swensen et al and included patient’s age, current or former smoker, diameter of the nodule, speculation and location. All LDCT had initially been interpreted by radiologists accredited in CT lung screening reporting following the National Comprehensive Cancer Network’s Clinical Practice Guidelines in Oncology: Lung Cancer Screening (version 1.2012), which considered as positive the same criteria from the National Lung Screening Trial.
Results:
In BRELT1 were recruited 790 current or former smokers, with a heavy smoking history. A total of 552 nodules were found in 312 positive LDCT at baseline (39%). LDCT follow up was performed in 89.1% of this population. From them 74 patients presented solid or semi solid nodules > 8mm in the highest diameter. According to ACR Lung-RADS™ 39 baseline LDCT were classified as 4A (52.7%), 6 as 4B (8.1%), 17 as 4X (22.9%) and 10 as 2 (13.5%). Follow-up LDCT showed reduction in the category in more than 80% of cases. Using the PTPM, 44 cases were considered at moderate risk (between 6 and 60%) and 30 cases of high risk for malignancy (over 60%). None was considered low risk (5% or less). Among 26 patients who underwent biopsy in BRELT1, we found 12 cases of lung cancer, of which 90% were stage IA or IB.
Conclusion:
The application of ACR Lung-RADS and PTPM associated with careful multidisciplinary assessment can help in the decision process. The follow-up of patients with positive nodules requires careful analysis of the main factors related to malignancy.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
OA17 - Aspects of Health Policies and Public Health (ID 397)
- Event: WCLC 2016
- Type: Oral Session
- Track: Regional Aspects/Health Policy/Public Health
- Presentations: 1
- Moderators:M. Kneussl
- Coordinates: 12/06/2016, 16:00 - 17:30, Schubert 1
-
+
OA17.05 - Survival in a Cohort of Patients with Lung Cancer: The Role of Age and Gender on Prognosis (ID 6310)
16:45 - 16:55 | Author(s): J.P. Franceschini
- Abstract
- Presentation
Background:
Lung cancer has a high incidence in Brazil; approximately thirty-four thousand new cases are diagnosed each year. In Brazil, as in other countries, the majority of patients diagnosed with lung cancer are elderly. There are few studies that evaluate demographic and clinical characteristics, disease staging, treatment modalities and survival in young patients, mostly carried out in developed countries. This study aimed to describe these aspects in patients with non-small cell lung cancer (NSCLC) according to age.
Methods:
Retrospective cohort consisted of patients diagnosed with NSCLC followed in a referral hospital in São Paulo. During the monitoring the survival time was evaluated. Survival functions were calculated using the method of Kaplan-Meier. The survival stratified by age was also obtained, according to distribution of percentages (less than 55; between 55 and 72 years; older than 72 years). Differences between survival curves were determined using the log-rank test.
Results:
From January 2000 to July 2015 790 patients were followed, 165 aged less than 55 years, 423 between 55 and 72 years and 202 older than 72 years. Higher incidence of adenocarcinoma was seen at the groups up to 72 years. 575 (73%) patients with advanced disease (IIIB-IV stages) were observed. The median five-year survival was 12 months [46-4]. The survival of patients in different age groups was not different.
*Chi-square test; † Kruskal-Wallis (Duncan test); ‡oneway ANOVA (Bonferroni test).<55 165 >55<72 423 >72 202 p Male n(%) 87 (53) 279 (66) 127 (63) 0.012* Smoke n(%) 136 (82) 363 (86) 165 (82) 0.34* Male 78 (90) 263 (94) 121 (95) 0.21* Female 58 (74) 100 (69) 44 (59) 0.10* Histological type n(%) 0.13* Adenocarcinoma 92 (56) 216 (51) 91 (45) Squamous Cell Carcinoma 52 (32) 170 (40) 91 (45) Staging n(%) 0.057* IA/IIIA 34 (21) 127 (30) 52 (26) IIIB/IV 131 (79) 294 (70) 150 (74) Deaths n (%) 83 (50) 232 (55) 105 (52) 0.56* Follow-up (months) Median[IIQ] 4.9 [1.3-13.2] 6.5 [2.0-16.3] 4.4 [1.4-12.9] 0.07†
Conclusion:
In the age group of younger patients (<55) women predominated, histological type adenocarcinoma was more frequent, and there were more patients with advanced stage at the diagnosis and a higher percentage of smokers in both genders.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
