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C.Y. Lee
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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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P1.08-018 - Positive N Stage is a Risk Factor for Survival in Five-Year Disease Free Survivors with Completely Resected Non-Small Cell Lung Cancer (ID 3935)
14:30 - 14:30 | Author(s): C.Y. Lee
- Abstract
Background:
Lung cancer has a poor prognosis and it has a small number of long term survival patients compared to other cancers. Therefore, there is a limitation in evaluating survival beyond 5 years after surgical treatment. The purpose of this study is to analyze risk factors of survival and late recurrence in these patients after 5 years disease free period.
Methods:
This is a retrospective analysis of patients who had at least 5 years disease free survival after surgical treatment for NSCLC at a single institute between January 1998 and December 2007. We excluded patients who received neo-adjuvant therapy, incomplete resection, or advanced stage (stage IIIb and IV).
Results:
463 (41.1%) out of 1126 patients were enrolled. 318 patients (68.7%) were male, and their mean age was 61.3 ± 9.7 years (range, 21.3 – 82.2). Pathologic N0 (337 patents, 72.8 %) and stage I (263 patents, 56.8 %) were dominant stage. Late recurrence occurred in 5.4 % (25 patients) after 5 years of surgery. In multivariate analysis, male, age (≤ 60 years), node positive, and late recurrence were independent risk factors for overall survival, while the node positive was the only independent risk factor for disease free survival on multivariate analysis (HR, 2.609; p=0.017; CI, 1.190 – 5.719).Table. Multivariate analysis of Overall Survival & Disease Free Survival
Variables HR p 95% CI Overall Survival Sex Female 1 Male 2.243 0.003 1.323-3.801 Age age < 60 1 60 ≤ age <70 2.647 <0.001 1.593-4.398 70 ≤ age 4.607 <0.001 2.605-8.149 p-N stage N0 1 N1+N2 1.809 0.003 1.231-2.660 Recurrence No 1 Yes 5.377 <0.001 3.316-8.719 Disease free survival p-N stage N0 1 N1+N2 2.609 0.017 1.190-5.719
Conclusion:
This study confirmed that late recurrence occurred in patients with no recurrence for 5 years after surgical resection, and it had a negative effect on overall survival beyond 5 years after operation. Furthermore, N positive (N1 or N2) was an independent risk factor for both overall survival and disease free survival. Therefore, careful follow-up is needed for the detection of late recurrence even in patients with five years disease free survival, and especially for node-positive patients. More studies are needed to clarify this point.
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P2.04 - Poster Session with Presenters Present (ID 466)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.04-001 - A Comparative Analysis of Long-Term Outcome of Thymoma between Video-Assisted Surgery and Open Resection from Multi-Center Study Data (ID 6297)
14:30 - 14:30 | Author(s): C.Y. Lee
- Abstract
Background:
To compare the oncologic results between video-assisted thoracoscopic surgery and open resection in early and locally advanced thymomas from multi-center study database using propensity score matching analysis.
Methods:
Data from 1546 participants in the Korean Association for Research on the Thymus were used to analysis for video-assisted thoracoscopic surgery(VATS) versus open resection from January 2003 to December 2013. We performed propensity score matching analysis for the outcomes of video-assisted thoracoscopic surgery versus thoracotomy lung resection (based on age, gender, MG symptom, tumor size, WHO histologic type, receiving neoadjuvant chemotherapy).
Results:
We excised the thymoma using VATS in 513 patients, while 1033 patients underwent open procedures. There were not significant differences between the 2 groups for the 5-year overall survival (p=.61), recurrence-free survival (p=.25), and complete resection (p=.38). The operative times, the hospital stay duration, and the chest tube indwelling time were significantly shorter in the VATS group compared to in the open group. Median follow-up duration was 50.13 months (IQR 26.61-79.60). The Masaoka-Koga stage was I/II/III, IV in 556/604/384 patients, respectively. We analyzed on the basis of propensity score matching. There were no significant difference in survival rate (p=0.882/0.632/0.597), recur-free survival (p=0.120/0.104/0.488), and R0 resection (p=0.945/0.656/0.007) between 3 grups in multivariable analysis.
Conclusion:
Patients undergoing VATS thymectomy had shorter the operative time and the hospital stay duration. Moreover, survival rate and recurrence-free survival are equivalent between VATS and open resection. Therefore, video-assisted thoracosopic surgery is feasible approach for early and locally advanced stage thymoma.
