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A. D'Silva
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MA06 - Locally Advanced NSCLC: Risk Groups, Biological Factors and Treatment Choices (ID 379)
- Event: WCLC 2016
- Type: Mini Oral Session
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:P. Van Houtte, M. Zemanová
- Coordinates: 12/05/2016, 16:00 - 17:30, Strauss 2
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MA06.01 - Overall Survival Characterization of Incidental N2 Non-Small Cell Lung Cancer over 14 Years at a Single Canadian Institution (ID 4751)
16:00 - 16:06 | Author(s): A. D'Silva
- Abstract
- Presentation
Background:
Incidental stage IIIA non-small cell lung cancer (NSCLC) cases have positive N2 mediastinal lymph node involvement discovered at the time of surgery, resulting in stage reclassification. These patients represent a small group within the stage III patient spectrum with limited data regarding their outcome. This study’s aim is to characterize the survival of incidental stage IIIA disease and compare these outcomes to patients diagnosed with stage II and IIIA disease.
Methods:
Using the Glans-Look Lung Cancer database and electronic patient charts, a retrospective review identified patients consulted at the Tom Baker Cancer Center from 1999 to 2012 who were defined as incidental stage III NSCLC. Their outcome was compared with stage II patients who underwent resection and stage IIIA patients treated with concurrent chemotherapy and radiation (CCR). These groups were selected for comparison because they represent patients who received the recommended standard of care for their respective diagnosis. A Kaplan-Meier analysis was conducted to compare overall survival (OS) among the groups.
Results:
Fifty-eight incidental stage III NSCLC patients were identified: median age was 63 years (SE ±10.3), 46.6% male, and 63.8% received adjuvant therapy. There were 225 individuals treated with CCR; median age 64 years (SE ±9.0), 56.0% male. The stage II group contained 248 individuals, the median age was 64 years (SE ±10.2), 53.6% were males, and 30.6% received adjuvant therapy. The OS of the incidental group was 47.4 months (95% CI 20.0-74.7). The OS for patients treated with CCR only was 24.0 months (95% CI 20.8-27.2) and 55.3 months (95% CI 43.7-66.9) for stage II resected cases. There was a significant difference in OS between CCR-treated stage IIIA and incidental cases (p = .001) but not between stage II and incidental (p = .264). The five-year survival rates were 44.6% (SE ±6.5) for incidental IIIA, 21.0% (SE ±2.7) for CCR-treated IIIA, and 46.9% (SE ±3.2) for resected stage II.
Conclusion:
This study demonstrates that incidental stage IIIA-N2 patients are a distinct group whose median OS closely resembled stage II patients. The benefit of resection for stage IIIA patients suggests that the traditional influence of stage in dictating treatment is changing. Further investigation is needed to identify which stage IIIA patients benefit the most. Ongoing analysis will include a comparison of progression-free survival between the three groups, impact assessment of post-operative treatment on OS, and a description of the diagnostic process evolution over time leading to an incidental N2 diagnosis.
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P1.01 - Poster Session with Presenters Present (ID 453)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Epidemiology/Tobacco Control and Cessation/Prevention
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.01-044 - Accelerometer-Determined Physical Activity and Sedentary Time among Lung Cancer Survivors (ID 4673)
14:30 - 14:30 | Author(s): A. D'Silva
- Abstract
Background:
Physical activity is an effective way to positively influence health outcomes among cancer survivors. Few studies have examined physical activity and sedentary behaviour among lung cancer survivors. Further, these studies have used self-report measures of physical activity, which may bias results (e.g., overestimation) and lead to incorrect conclusions. Only one study to date has reported on objectively-assessed sedentary behaviour among lung cancer survivors. The primary aim of this currently ongoing study is to determine the prevalence of objectively-assessed physical activity and sedentary time among lung cancer survivors.
Methods:
Lung cancer survivors in Southern Alberta diagnosed between 1999 and 2014 are currently being recruited to participate. Eligibility criteria include: confirmed non-small cell lung cancer, completed treatment, and not living in hospice/palliative care. Consenting participants wear an Actigraph[®] GT3X+ accelerometer on their hip for seven days. Time spent sedentary, in light and in moderate-to-vigorous intensity physical activity are derived from the accelerometer data and processed using 60-second epochs. Physical activity and sedentary behaviour accumulated in 10 minute and 30 minute continuous bouts will be examined.
Results:
Recruitment began in June, 2016. A total of 660 survivors were invited and 113 have agreed to participate. Of the 374 survivors that did not respond, most indicated they were not interested (n=115). Others denied having lung cancer (n=6) or had invalid contact information (n=27). Six were deceased. Currently the response rate is 18.2%. Of the 113 that consented, eight participants withdrew due to health concerns (n=4), time constraints (n=2), and loss of interest in the study (n=2). Of the 105 participants, the median age at diagnosis was 66 years, and 72 years at recruitment, the majority were female (n=62), and 85 had a smoking history. Adenocarcinoma was the most common diagnosis (n=65). The majority of participants were diagnosed stage I (n=53) with others diagnosed at stage II (n=23), III (n=18), and IV (n=11). Overall, 65 survivors underwent a lung resection while 18 of those received adjuvant therapy. Other treatments included concurrent chemotherapy and radiation (n=11) and radical radiation alone (n=23).
Conclusion:
This study will be the first to report on objectively assessed physical activity and sedentary time among a population-based sample of lung cancer survivors. Despite inherent difficulties of this type of research (e.g., older population), the positive response rate suggests high participation interest. We expect to reach our recruitment target of 140 patients by September, 2016, with data analysis completed in November, 2016.
