Author of

• 16751

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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)

  • 16811

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    P1.05-060 - Adherence to Surveillance Guidelines in Resected NSCLC: Physician Compliance and Impact on Outcomes (ID 4624)

    14:30 - 14:30  |  Author(s): K. Remo
    • Abstract

    Background:
    Guidelines on resected NSCLC have varying recommendations on appropriate post-operative surveillance. There is general consensus that patients require follow up q6m with clinic visits or CT scans for the first 2 y. This study evaluated compliance with surveillance guidelines and the impact on outcomes.
    
    Methods:
    The BC Cancer Agency provides comprehensive cancer control for a population of 4.5 million. Inclusion criteria included referred patients from 2005-2010, resected stage Ib/II NSCLC, minimum 2 y f/u at the BCCA, no prior lung cancer diagnosis. Retrospective chart review collected baseline parameters, follow up visits, CT imaging, recurrence and death.
    
    Results:
    479 were referred and 263 were eligible. Baseline characteristics median age 68, male 52%, current/former/never smoker 38/52/10%, stage Ib/II 51/49%, squamous/non 30%/70%, wedge/lobectomy/pneumonectomy 8/76/16%, adjuvant chemotherapy 46%. Adherence to 4 interventions in 2 y: clinic visits 62%, CT scans 18%, visit and/or CT 67%. Multivariate analysis (MVA) for predictors of guideline adherence demonstrated only stage was significant. Recurrence rate was 46% at 2 y with patterns of recurrence and treatment in table 1. Surveillance below vs per/above guidelines; PFS 26.6 m vs 22 m (p=0.54), OS 47 m vs 41.8 m (p=0.27).

    	Follow up visits and/or CT scans below guidelines n=87	Follow up visits and/or CT scans per or above guidelines n=176	p value
    Recurrence within 2 years	32 (37%)	88 (50%)
    Method of detection			0.41
    Surveillance	18 (56%)	41 (47%)
    Patient	14 (44%)	47 (53%)
    Distribution of recurrence			0.16
    Second primary	1 (3%)	2 (2%)
    Locoregional recurrence only	10 (31%)	14 (16%)
    Metastatic	21 (66%)	73 (82%)
    Curative intent treatment at recurrence	5 (16%)	6 (7%)	0.16
    Palliative chemotherapy	7/27 (26%)	32/82 (39%)	0.25

    
    
    Conclusion:
    Compliance with follow up recommendations for resected NSCLC was 67% in our study. Guideline conformity did not increase the rate of curative intent therapy at recurrence due to metastatic presentation nor did it increase the proportion of patients treated with palliative chemotherapy. Better adjuvant treatment and surveillance options need to be developed for resected NSCLC.