Virtual Library
Start Your Search
Luiz H. Araujo
Author of
-
+
P1.02 - Biology/Pathology (ID 614)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
-
+
P1.02-036 - Fine Needle Aspiration as a Diagnostic Tool in Lung Cancer: Worth Pursuing? (ID 9581)
09:30 - 09:30 | Presenting Author(s): Luiz H. Araujo
- Abstract
Background:
The diagnosis of lung cancer can be challenging due to different forms of disease presentation, coupled with institutional familiarity with specific techniques. Transthoracic fine needle aspiration (FNA) is relatively simple and inexpensive, yielding diagnostic material in 70-95% of cases. In the era of personalized oncology where immunohistochemical and molecular assays may be required, the role of FNA to provide enough material should be reassessed.
Method:
This is a prospective study designed to evaluate the feasibility and safety of FNA as a primary technique in the diagnosis of lung tumors. Patients were randomized in a 1:1 ratio into two arms, one using conventional FNA needle (control arm) and another using coaxial needle (experimental arm). Eligible patients were at least 18 years old and had a lung mass suspicious of lung cancer. The procedure was performed in an outpatient clinic, under local anesthesia, by an experienced thoracic surgeon in the presence of a pathologist. The primary endpoint was a positive cell block containing at least 40% of neoplastic cells, a surrogate for successful additional assays. We present the first interim analysis. This study was approved by the Ethics Committee.
Result:
Between January 2013 and May 2015, 34 patients were enrolled, 17 in each arm. The cohort was mostly comprised of males (62%) and smokers (91%), with a median age of 66 years (range 51-85). Most cases were assessed with a computed tomography (94%), with target tumor measuring a median of 8.2 cm (range 1-13 cm). Baseline characteristics were well balanced between the 2 arms, except for gender (82% males in the experimental arm, 41% in the control arm). A positive cell block was acquired in 9 (53%) and 7 (41%) cases in the experimental and control arms, respectively. Altogether, a positive cell block was acquired in 16 cases (47%). A diagnosis was obtained in 82% of cases, but histological subtyping was only possible in 73%. The cell block positivity rate was significantly associated with histological subtyping (p<0.001). Local pain was the only adverse event, reported in 2 cases in each arm.
Conclusion:
FNA was a safe procedure in both arms, but yielded enough tumor material in less than half patients and was less than optimal to determine histological subtyping. No relevant difference was observed between conventional and coaxial needle, neither for safety nor for efficacy. FNA alone should not be considered a standard procedure in most cases suspicious for lung cancer.
-
+
P1.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 692)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
-
+
P1.06-024 - Outcome of Non-Small Cell Lung Cancer Patients Treated in the Private Health Care in Brazil (ID 9010)
09:30 - 09:30 | Presenting Author(s): Luiz H. Araujo
- Abstract
Background:
Developing countries often present a dichotomous health care system, where patients may be treated in either public or private institutions that differ substantially in terms of level of access to diagnostic and therapeutics procedures. Herein, we present the first report of this comprehensive study to assess real-world data in non-small cell lung cancer (NSCLC) patients treated in the private health care in Brazil.
Method:
This is a prospective study of lung cancer patients treated in a private health care institution, comprising six unities in Rio de Janeiro and surroundings. Eligible patients were at least 18 years old and had a histology-proven diagnosis of lung cancer between July 2012 and February 2017. For this analysis, only NSCLC patients with an invasive component were included. Patients or relatives were contacted by telephone to ensure that all information was annotated. Data quality was certified by regular monitoring. This study was approved by the local Research Ethics Committee.
Result:
Six hundred twenty-eight patients were enrolled. Eighty-three were excluded in this analysis due to small-cell (57), carcinoid (5), in situ carcinoma (5), and other histological subtypes (16). The final report comprises 545 NSCLC patients, predominantly of non-squamous histology (76.5%). Median age was 68 years (range 21-93), and most cases were males (54.3%). Most patients were current (28.3%) or former (49.7%) smokers, diagnosed in advanced stages (stage III in 20.7% and stage IV in 57.2%). Treatment had a curative intent in 38.9% of times, and included surgery in 29.4%. Palliative chemotherapy was delivered in 64.5% of times, while adjuvant and neoadjuvant chemotherapy was used in 10.2% and 5.4%, respectively. Radiotherapy was used in 53.9% of cases. Molecular testing was available for 49.3% of cases, mostly in non-squamous histology (92.8%) and in advanced stages (stages III/IV in 74.8%). Median overall survival was 25.3 months (95% CI 22.0-28.6). Factors significantly correlated to OS were disease stage, performance status, tumor grade, gender, and weight loss (p<0.01 in all). Among patients with metastatic or recurrent disease, OS was significantly longer in those with a molecular testing (p<0.01).
Conclusion:
To our knowledge, this is the most comprehensive and best-annotated study in this scenario. Outcomes were favorably similar to the current literature from developed countries in all stages, which suggest that data generated from international clinical trials should be reproducible locally. Our dataset may serve as a foundation to guide resource allocation in the years to come.
