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Y. Kidokoro
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-058 - Prognostic Factors of Post-Recurrence Survival in Resected Stage I Non-Small Cell Lung Cancer (ID 3819)
14:30 - 14:30 | Author(s): Y. Kidokoro
- Abstract
Background:
Recurrence after surgical resection is a major obstacle in the cure and long term survival, and has become the most common cause of death. However prognostic factors and efficacy of the therapy after recurrence remain controversial. We evaluated the prognostic factors of post-recurrence survival (PRS) in patients of resected stage I NSCLC.
Methods:
Of the 551 patients who underwent a complete resection for stage I NSCLC between 2005 and 2013, 89 (16.2%) patients who experienced a postoperative recurrence were selected for this retrospective study. Case of preoperative therapy and death within 30 days of operation were excluded. Clinicopathological factors were analysed for PRS by univariate and multivariate analyses. Univariate and multivariate analyses were performed by using the Cox proportional hazards model.
Results:
89 patients experienced recurrence during a median follow-up period of 54.0 months. The median recurrence free interval (RFI) was 16.0 months. The 1-year PRS and 3-year PRS were 65.6% and 44.7%, respectively. The pattern of recurrence was loco-regional in 24(27.0%), and distant in 65(73.0%). The most common organ sites of recurrence were contralateral lung in 42 patients, the ipsilateral thorax in 24, bone in 24, brain in 12, liver in 9. Univariate analysis indicated that male sex (p=0.035), smoking history (p=0.034), larger tumor size over 25mm (p=0.008), stage IB (p=0.044), squamous cell carcinoma (p=0.001), RFI within 16 months (p=0.011), presence of symptoms (p=0.001), bone metastasis (p=0.001), liver metastasis (p=0.009) and not having received any treatment (p<0.001) were significant prognostic factors of worse PRS. Multivariate analysis revealed that larger tumor size over 25mm (p=0.05), RFI within 16 months (p=0.05) and no treatment for recurrence (p<0.001) were the independent prognostic factors for poor PRS. The result of multivariate analysis of PRS determined that post-recurrence therapy had a strong impact on PRS. Therefore, we further examined PRS in 61 patients who underwent any post-recurrence therapy. For patients receiving treatment for recurrence, bone metastasis (p=0.042) was a significant predictive factor of worse PRS, while treatment with EGFR-TKIs (p=0.045) was a good prognostic factor.
Conclusion:
This study showed that tumor size, RFI, and post-recurrence therapy were prognostic factors for PRS. In the patients who underwent treatment for recurrence, bone metastasis and treatment with EGFR TKIs were independent prognostic factors. Although further validation is needed, this information is important for future design of clinical trials for therapy after recurrence.
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-052 - Comparison Study of Perioperative Outcomes in Robotic, Video-Assisted Thoracic Surgery, and Thoracotomy Approaches for Lung Cancer (ID 5341)
14:30 - 14:30 | Author(s): Y. Kidokoro
- Abstract
Background:
Robotic surgery for lung cancer has not widely spread because of the lack of definitive advantage compared to conventional approaches, specifically video-assisted thoracic surgery (VATS). Some studies have reported that postoperative complication in robotic surgery is superior for unclear reasons. The aim of this study is to compare the perioperative outcomes, particularly pointing out postoperative complication among robotic, video-assisted thoracic surgery (VATS) and thoracotomy approach in non-small cell lung cancer (NSCLC).
Methods:
We performed a retrospective review of NSCLC patients who underwent curative anatomical resection in our hospital from January 2011 to April 2016. There were 346 lobectomy cases and 76 segmentectomy cases. The patients were classified into four groups (robotic, VATS, open conversion from VATS, and thoracotomy) and were compared for differences in perioperative outcomes.
Results:
Total 422 patients (43 robotic, 265 VATS, 30 open conversion from VATS, and 84 thoracotomy) were included in the analysis. Clinical and pathological stage showed earlier in robotic and VATS cases. Operative time (min), bleeding amount (gram) and drainage period (days) for robot, VATS, conversion and thoracotomy were 247/20/2, 188/10/2, 246/100/2, 225/ 92.5/2 respectively(p<0.0001). In the incidence of all, over G3, respiratory over G3 postoperative complications robotic surgery showed significantly lowest among them and there were neither conversion to thoracotomy nor operative/hospital mortality in robotic surgery.
Conclusion:
In our initial results of robotic surgery, lower incidence of operative morbidities is one of the advantageous features. Important issue whether robotic surgery is established as a minimally invasive approach for NSCLC or not should be verified.
