Abstract 1969
Background
In early stage non-small cell lung cancer (NSCLC), the anatomical resection with lymph node dissection is a standard procedure as a curative intent while wedge resection is considered as a passive treatment. However, optimal treatment strategy for elderly ( > = 80 y.o.) patients remains controversial. We attempted to disclose the role of wedge resection without lymph node dissection as a treatment option in octogenarians or older.
Methods
Among 671 patients with clinical stage IA NSCLC with whole tumor size is 2 cm or less and consolidation to tumor ratio is more than 0.5 underwent R0 resection in three institutions between 2010 and 2015, 55 octogenarians or older were investigated about clinicopathological findings and prognosis based on surgical procedures and lymph node dissection status.
Results
The median follow-up time was 35 months. The 3-year overall survival (OS) rate for octogenarians or older was 83.8% (95% confidential interval (CI): 69.7-91.7%). No significant differences for OS were detected among three surgical procedures (3-year OS rate: wedge resection: 88.5% (95%CI: 68.4-96.1%), segmentectomy: 83.3% (95%CI: 27.3-97.5%) , and lobectomy: 78.9% (95%CI: 53.0-91.6%), P = 0.72) or lymph node dissection status (3-year OS rate: ND0: 88.9% (95%CI: 69.4-96.3%) and ND1 or 2: 77.0% (95%CI: 50.8-90.4%), P = 0.95). The multivariable Cox regression analysis revealed that male gender (Hazard ratio (HR): 4.7 (1.1-20.2), P = 0.039) and larger solid tumor size (HR: 5.8 (1.1-29.9), P = 0.035) were independent poor prognostic factors whereas surgical procedure (wedge resection vs. segmentectomy or lobectomy) (HR: 0.50 (0.15-1.7), P = 0.27) was not. In another model, lymph node dissection status (ND0 vs. ND1 or 2) (HR: 0.51 (0.15-1.8), P = 0.28) was not found to be a prognostic factor.
Conclusions
In octogenarians or older with early stage NSCLC, wedge resection without lymph node dissection might be an alternative option to lobectomy or segmentectomy with lymph node dissection.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4294 - The Patient Voice: An Irish Survey of Nutrition Attitudes & Access to Dietetic Care Throughout the Cancer Journey
Presenter: Erin Stella Sullivan
Session: Poster Display session 1
Resources:
Abstract
1925 - Homcology: home chemotherapy delivery in a simultaneous care project for frail advanced cancer patients
Presenter: Claudio Chini
Session: Poster Display session 1
Resources:
Abstract
4701 - Treatment-related adverse events and tolerability in patients with advanced non-squamous non-small cell lung cancer treated with first-line checkpoint inhibitors in combination with chemotherapy
Presenter: Ruth D'cunha
Session: Poster Display session 1
Resources:
Abstract
2985 - Clinical utility of a systematic toxicity assessment form (STAF) in patients with breast cancer receiving adjuvant or neoadjuvant therapy.
Presenter: Jwa Hoon Kim
Session: Poster Display session 1
Resources:
Abstract
2358 - Physicians’ satisfaction with Health-related quality of life (HRQoL) assessment in daily clinical practice using electronic patient-reported outcome (ePRO) for cancer patients.
Presenter: Guillaume Mouillet
Session: Poster Display session 1
Resources:
Abstract
5172 - Predictors of Survival in Patients with Incurable Cancer
Presenter: Erin Stella Sullivan
Session: Poster Display session 1
Resources:
Abstract
2281 - Patients and Physicians' Satisfaction with Telemedicine (TM) in Cancer Care and Factors that Correlate with a Positive Patient’s Experience
Presenter: Hurria Gondal
Session: Poster Display session 1
Resources:
Abstract
2193 - Adherence to ESMO 2014 guidelines on bone-targeting agent (BTA) initiation for breast and prostate cancer patients: real-world insights from practicing European physicians
Presenter: Alex Rider
Session: Poster Display session 1
Resources:
Abstract
2200 - Use of skeletal-related events preventive agents in patients with solid tumours and bone metastases in central Denmark
Presenter: Anders Boysen
Session: Poster Display session 1
Resources:
Abstract
2504 - Inadequacy of current definition and staging system of Medication-Related Osteonecrosis of Jaw (MRONJ) released by AAOMS : a Computed Tomography study in 151 cancer and myeloma patients
Presenter: Vittorio Fusco
Session: Poster Display session 1
Resources:
Abstract