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H. Xiong
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OA 04 - Surgery from Minimal to Radical (ID 661)
- Event: WCLC 2017
- Type: Oral
- Track: Surgery
- Presentations: 1
- Moderators:J. Lee, A. Chang
- Coordinates: 10/16/2017, 15:45 - 17:30, Room 311 + 312
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OA 04.03 - Primary Tumor Resection versus Maintenance Therapy for Patients with Oligometastatic Non-Small Cell Lung Cancer (ID 8132)
16:05 - 16:15 | Author(s): H. Xiong
- Abstract
- Presentation
Background:
To evaluate (1) the potential effect of primary tumor resection, an aggressive local consolidative therapy, for patients with oligometastatic NSCLC on 3 year overall survival; (2) the surgical outcomes in the treatment of patients with oligometastatic NSCLC; (3) the potential clinical factors predicting survival in order to better select patients for surgery.
Method:
According to the extent of pulmonary resection, the patients were divided into two subgroups. A. intent to cure (ITC: removal of total or primary pulmonary lesions); B. intent to biopsy (ITB: preservation of major lesions, only diagnostic biopsy via minimally invasive approach). M stage classified based on 8th UICC/AJCC TNM M categories.
Result:
From Jan 2002 through Dec 2015, a total of 115 consecutive metastatic NSCLC patients were enrolled from Peking University Cancer Hospital. The 3-year overall survival (OS) of ITC and ITB were 64.3% and 34.9% (log-rank p = 0.0009), respectively. Multivariate cox proportional regression analysis identified multiple station lymph nodes (LN) and bone involvement may be prognostic indicators. Figure 1Figure 2
Conclusion:
The current findings suggest that aggressive surgical therapy can extend the survival in selected stage IV NSCLC patients, and should be further explored in phase 3 trials as a standard treatment option in this clinical scenario.
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-053 - Genomic Challenges for Lung Cancers with Multiple Pulmonary Sites of Involvement (ID 9918)
09:30 - 09:30 | Author(s): H. Xiong
- Abstract
Background:
Patients with lung cancer who harbor multiple pulmonary sites of disease have been challenging to classify. Although the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee propose to tailor TNM classification of multiple pulmonary sites of lung cancer to reflect the unique aspects of four different patterns of presentation, tough challenges faced by clinicians are still not easily overcome.
Method:
Surgical tumor and normal tissue specimens were collected from six patients who were diagnosed with pathologically confirmed multiple lung cancers, with each tumor in the separate lobe, and treated at Beijing Cancer Hospital, Peking University, Beijing, China. Whole-exome sequencing was used to depict the genomic profiles of each tumor, and the average sequencing depth was 123× per sample (range, 84× to 154×; s.d., 19×).
Result:
In this study, we analyzed genomic profiles of 12 tumors from 6 patients with multiple lung cancers. Eight tumors from 4 patients demonstrated distinct genomic profiles, suggesting all were independent primary tumors, which were consistent with comprehensive histopathological assessment. Noteworthy common genomic characteristics were seen in 4 tumors from 2 patients. Compared with TCGA lung cancer cohort, one out of 6 patients carried significantly higher somatic nonsynonymous mutational burden, which were also discrepant between two separate lesions. Figure 1
Conclusion:
The current findings suggest that the tailor TNM classification of multiple pulmonary sites of lung cancer still encounter real-world challenges. A deeper understanding of the spatial and temporal dynamics of the carcinogenesis and evolution of lung cancer will be required to address these challenges.
