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K. Hayasaka
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OA19 - Translational Research in Early Stage NSCLC (ID 402)
- Event: WCLC 2016
- Type: Oral Session
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:G. Heller, G. Goss
- Coordinates: 12/07/2016, 11:00 - 12:30, Schubert 3
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OA19.07 - Difference of Postoperative Survival Due to the Type of EGFR Gene Mutation in Surgically Resected Lung Adenocarcinomas (ID 4726)
12:05 - 12:15 | Author(s): K. Hayasaka
- Abstract
- Presentation
Background:
Epidermal growth factor receptor (EGFR) gene mutation is a robust prognostic factor in patients with advanced lung adenocarcinomas. Recently, on the other hand, there are some reports proposing the difference of survival due to the type of EGFR mutation. In this study, we analyzed the difference of postoperative survivals between two most common mutations, that is, exon 19 deletions (DEL) and exon21 L858R (PM), using multi-institutional data of patients with surgically resected lung adenocarcinomas.
Methods:
We retrospectively collected 1,063 consecutive patients who underwent surgical resections for lung adenocarcinoma between 2005 and 2012 in five institutions, and who were examined their EGFR mutation status. The patients with minor EGFR mutations were excluded. We compared their clinicopathological characteristics among DEL, PM, and wild type (WT) group. We also analyzed postoperative recurrence-free survival (RFS) and overall survival (OS) according to the type of EGFR mutation.
Results:
The number of patients with DEL, PM, and WT was 218 (20.5%), 301 (28.3%), and 544 (51.2%) respectively, and their median follow-up period was 47.6 months. The patients of PM were older and earlier pathological staged than those with DEL, whereas no significant difference was observed among other clinicopathological factors. Five-year RFS and OS of DEL, PM, and WT were 67.3/85.9%, 76.4/88.6%, 59.2/71.5%, respectively, and both survivals of each mutant were significantly better than those of WT. Regarding the difference between DEL and PM, RFS curve of DEL was significantly worse than that of PM (p = 0.027), but OS curves of both mutant weren’t significantly different. (p = 0.16). In multivariate analysis, the type of EGFR mutation (DEL vs PM) was not an independent factor both in RFS and OS.
Conclusion:
Exon 21 L858R might be a more favorable recurrence-risk factor than exon 19 deletions in patients with surgically resected lung adenocarcinomas.
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P3.04 - Poster Session with Presenters Present (ID 474)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.04-021 - Readmission Rate is Not Increased with Shortened Hospital Stay after Lung Cancer Surgery (ID 4844)
14:30 - 14:30 | Author(s): K. Hayasaka
- Abstract
Background:
In health economics, keeping costs down is a great concern. Early discharge has been enabled after surgery for lung cancer by clinical pathways, preoperative rehabilitation and the introduction of Enhanced Recovery After Surgery (ERAS) protocols. However, even if a shortened hospitalization has a benefit for hospital management, it has not been clarified whether it has a good influence on the patient’s recovery after surgery. In this study, we examined the relationship between a shortened hospitalization and patient recovery after lung cancer surgery; in particular, we focused on the rate of rehospitalization within 30 days after discharge.
Methods:
We investigated the postoperative course of 318 patients who underwent lung cancer surgery from April 2013 through February 2016. Based on the execution of ERAS, we divided the patients into a shortened group (ERAS performed) and a usual group (ERAS not performed), and compared the rates of rehospitalization and postoperative complications.
Results:
There were 202 men and 116 women, and their median age was 71 years. The shortened group contained 90 cases, and the usual group contained 228 cases. Limited resections were carried out in 19 of 90 patients in the shortened group and in 72 of 228 patients in the usual group (p=0.06). The median duration of postoperative hospitalization was 4 days in the shortened group and 6 days in the usual group (p < 0.001). The incidence of complications was 23.3% (21/90) in the shortened group and 28.0% (64/228) in the usual group (p = 0.38). The rate of rehospitalization within 30 days after surgery was 6.7% (6/90) in the shortened group vs 4.4% (10/228) in the usual group (p = 0.40). In addition, one case in each group required rehospitalization within one week after discharge; thus, there was no significant difference in incidence between groups.
Conclusion:
Health economics is different throughout the world. The timing of discharge depends on the discretion of each institution. Although this study was carried out in a non-randomized setting, we revealed that a shortened hospital stay did not increase the postoperative complication and readmission rates of patients who underwent surgery for lung cancer. Shortening of hospital stay by the introduction of ERAS and other challenges could provide a benefit for patient and hospital management.
