演題抄録

International Session(Poster)

開催概要
開催回
第51回・2013年・京都
 

Survival and the Extent of Metastases in Advanced Non-squamous NSCLC

演題番号 : ISP-25

[筆頭演者]
Dong Soo Lee:1 
[共同演者]
Jin Hyoung Kang:2、Chang Geol Lee:3、Seoung Jun Kim:4、Young Jin Choi:5、Kyo Young Lee:5、Yeon Sil Kim:1

1:Department of Radiation Oncology, Seoul St. Mary's Hospital, Korea、2:Department of Medical Oncology, Seoul St. Mary's Hospital, Korea、3:Department of Radiation Oncology, Severance Hospital, Korea、4:Department of Internal Medicine, Seoul St. Mary's Hospital, Korea、5:Department of Pathology, Seoul St. Mary's Hospital, Korea

 

Purpose: A number of prognostic factors related to overall survival (OS) have been addressed in advanced non-small cell lung cancer (NSCLC). This study was conducted to determine the impact of whole-body metastatic regions on survival outcome in advanced non-squamous NSCLC.Materials and Methods: Between March 2005 and February 2011, 112 eligible patients with newly confirmed stage IV non-squamous NSCLC, available for epidermal growth factor receptor (EGFR) mutation status 18-21 analysis, and accessible for the determination of pretreatment whole-body metastatic regions were enrolled in this retrospective study. The total number of synchronous metastatic regions was scored according to the following disease sites: abdomen/pelvis; lung to lung or pulmonary lymphangitic spread; bone; pleura and/or pleural effusion and/or pericardial effusion; neck and/or axillary lymph nodes; other soft tissue; brain. Results: The median age of the cohort was 65 (range, 31-88) years, and 61 (54.5%) patients were male. The median whole-body metastatic score was 2 (range, 1-6), and bone and lung to lung were the most common metastatic sites. EGFR mutations were observed in 40 (35.7%) patients with a deletion in exon 19 and Leu858Arg mutation in exon 21 being detected in 16 (40.0%) and 19 (47.5%) patients, respectively. Multivariate analysis for OS revealed that treatment factors (p=0.005), performance status (p=0.006), whole-body metastatic score (p<0.001), and EGFR mutation status (p=0.095) were significantly or marginally associated with OS. Conclusion: The results of the present study demonstrated that whole-body metastatic extent strongly affects survival outcome, even after adjustment for other significant variables in advanced non-squamous NSCLC. The clinical validity of more curative multimodal approaches in cohorts with limited metastases remains to be explored.

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