1192P - Influence of gastrointestinal tract cancer history on the outcomes of lung cancer surgery: Extended inclusion criteria for clinical trials

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Non-Small-Cell Lung Cancer, Early Stage
Cancer in Special Situations
Surgery and/or Radiotherapy of Cancer
Presenter Keiju Aokage
Citation Annals of Oncology (2014) 25 (suppl_4): iv409-iv416. 10.1093/annonc/mdu347
Authors K. Aokage1, M. Okada2, K. Suzuki3, S. Nomura4, S. Suzuki1, N. Tsubokawa2, T. Mimae2, A. Hattori3, T. Hishida1, J. Yoshida1, M. Tsuboi1
  • 1Division Of Thoracic Surgery, National Cancer Center Hospital East, 2778577 - Kashiwa/JP
  • 2Department Of Surgical Oncology, Hiroshima University, 7348551 - Hiroshima/JP
  • 3Division Of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo/JP
  • 4Resarch Center For Innovative Oncology, Clinical Trial Section, National Cancer Center Hospital East, 277-8577 - Kashiwa/JP

Abstract

Aim

Clinical trials often exclude patients with a history of cancer treatment during the 5 years preceding the investigation. This study aims to evaluate whether a history of gastrointestinal (GI) tract cancer affects the prognosis of patients who undergo surgery for non-small cell lung cancer (NSCLC) to extend inclusion criteria for clinical trials.

Methods

Multi-institutional, individual data from patients with NSCLC resected between 2000 and 2013 were collected. The patients were divided into 2 groups: those with a history of GI tract cancer (GI group) and those without any history (non-GI group). We compared the outcomes with well-matched groups using propensity scoring to minimize bias related to the nonrandomness. The influence of GI tract cancer stage, disease-free interval (DFI), and treatment method for GI tract cancer on the outcome of NSCLC was examined.

Results

We analyzed 196 patients in the GI group and 3732 in the non-GI group. In unmatched cohort, multivariate analyses showed that a history of GI tract cancer did not affect overall survival (OS: hazard ratio [HR] 0.95; 95% confidence interval [CI] 0.68-1.32) or recurrence-free survival (RFS: HR 0.94; 95%CI 0.71-1.25). Independent predictors of poor prognosis included older age, male sex, high carcinoembryonic antigen levels, and advanced clinical stage of NSCLC. The two groups in matched cohort demonstrated equivalent OS (OS: HR 0.90; 95%CI 0.60-1.33) and RFS (RFS: HR 0.84; 95%CI 0.60-1.18), even in patients with clinical stage I. GI tract cancer stage, DFI, and treatment method for GI tract cancer were not associated with outcomes.

Conclusions

Patients with well-controlled GI tract cancer treated during the last 5 years can be included in randomized controlled trials for NSCLC.Patients with well-controlled GI tract cancer treated during the last 5 years can be included in randomized controlled trials for NSCLC.

Disclosure

All authors have declared no conflicts of interest.