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Post ablation chemotherapy improves outcomes following percutaneous radiofrequency ablation for local control of solid lung tumors in elderly patients
2013 SIOG Poster Abstracts
Keywords: Lung doi:10.1016/j.jgo.2013.09.036
Track 1 - Solid Tumours in the Elderly Lung cancer in eldery patients P033 Post ablation chemotherapy improves outcomes following percutaneous radiofrequency ablation for local control of solid lung tumors in elderly patients P. Andrew1,*, S. O'Connor2, S. Jerat3, R. Lee-Ying4. 1Department of Internal Medicine, The Ottawa Hospitals, Ottawa, Canada; 2City University, London, United Kingdom; 3ATLAS Medical Research Inc., Edmonton; 4Department of Medical Oncology, Tom Baker Cancer Centre, Calgary, Canada Introduction: With a burgeoning population of elderly patients with lung cancer deemed non-surgical, increasing utilization of minimallyinvasive, safe, repeatable, tissue-preserving techniques such as percutaneous radiofrequency ablation (RFA) is occurring for the management of solid tumors. However, it is unknown whether a strategy of RFA plus post ablation chemotherapy (PAC) improves locoregional and survival outcomes in aged patients. Objectives: We compared local tumor recurrence and survival outcomes of RFA plus PAC versus RFA alone for management of primary and metastatic solid lung tumors in non-surgical patients. Methods: Searched PubMed, the Cochrane Library, EMBASE, and CANCERLIT databases from January 2000 to December 2012. Blinded duplicate screening for data extraction. Population was deemed nonsurgical, with solid lung tumors, both primary and/or metastatic. Generated aggregate effect estimates from constituent studies for three outcomes (e.g., local tumor progression [LTP], overall survival [OS], and disease-free survival [DFS]) with comparison of pooled fixed effect analyses concerning RFA plus PAC versus RFA alone. Results: RFA plus PAC group versus RFA alone group: LTP of 15% over median follow-up of 31 months [range 12 to 59] versus 19% over median follow-up of 21 months [range 12 to 29]; odds ratio (OR) 0.73 (95% CI: 0.61-0.86, p b 0.05) at 12 month follow-up. OS was 89% versus 78%, respectively, at 12 month follow-up; OR 1.52 (95% CI: 1.16-2.00, p = 0.003). DFS was 90% versus 82%, respectively, at 12 month follow-up; OR 3.18 (95% CI: 2.04-4.96, p b 0.05). Forrest plots for the outcomes of LTP, OS, and DFS are shown. Sensitivity analyses were robust, publication bias relatively narrow, and Q statistic b21; p N 0.13 for all outcomes. Image:
S39
Conclusion: A strategy of RFA plus PAC retards LTP, but lengthens both OS and DFS. Elderly patients most likely to benefit from this strategy would be non-surgical candidates with relatively good performance status who could tolerate both RFA and PAC. Disclosure of Interest: None Declared Keywords: Lung, Translational research doi:10.1016/j.jgo.2013.09.037
Track 1 - Solid Tumours in the Elderly Lung cancer in eldery patients P034 Lung cancer in women: Do tumors behave differently in the elderly? A prospective comparison of World07 data base R. Gironés1,* on behalf of ICAPEM, M. Provencio2 on behalf of ICAPEM, M. Majem3 on behalf of ICAPEM, P. Garrido4 on behalf of ICAPEM, E. Felip5 on behalf of ICAPEM, E. Felip5 on behalf of ICAPEM, N. Viñolas6 on behalf of ICAPEM, A. Artal7 on behalf of ICAPEM, L. Isla8 on behalf of ICAPEM, E. Carcereny9 on behalf of ICAPEM, C. García-Campelo10 on behalf of ICAPEM, P. Lianes11 on behalf of ICAPEM, R. De las Peñas12 on behalf of ICAPEM and ICAPEM: Asociación para la investigación de cáncer de pulmón en mujeres. 1Medical Oncology, Hospital Lluis Alcanyis, Xàtiva; 2 Medical Oncology, Hospital Puerta del Hierro, Madrid; 3Medical Oncology, Hospital Sant Pau, Barcelona; 4Medical Oncology, Hospital Ramón y Cajal, Madrid; 5Medical Oncology, Hospital Vall d'Hebron; 6 Medical Oncology, Hospital Clinic, Barcelona; 7Medical Oncology, Hospital Miguel Servet; 8Medical Oncology, Hospital Lozano Blesa, Zaragoza; 9Medical Oncology, Hospital Germans Trias i Pujol, Badalona; 10 Medical Oncology, Complexo Hospital A Coruña, Coruña; 11Medical Oncology, Hospital de Mataró, Barcelona; 12Medical Oncology, Hospital de Castellón, Castellón, Spain1On behalf of ICAPEM.2ICAPEM: Asociación para la investigación de cáncer de pulmón en mujeres. Introduction: Lung cancer appears to behave differently in women.Women are more likely to present with adenocarcinoma, diagnosed at localized disease and have better survival(1).It's unclear, however, whether elderly lung cancer women had a different natural history than younger Objectives: To investigate differences in epidemiology,types of presentation,tumor characteristics,treatment and survival between younger and older women with lung cancer included in a prospective Spanish multicenter registry Methods: Wolrd07 is an epidemiological multicentre prospective registration of women with lung cancer attended at Spanish institutions. From October 2007 to October 2012. Last follow up:April 2013. Clinicopathologic and tumor information was prospectively collected and compared between age groups. Survival was determined as the interval form the date of cancer diagnosis to the date of death. The institution’s ethical review board approved this study. All of the patients provided written informed consent Results: 38 institutions registered 2081 patients. Patient’s characteristics are reported in table. Caucasian race (98%,p:0,899). Some hormonal factors shown statistical differences; however number of children was similar (median: 2; 0-10). Smoking habits differ from both groups. Median pack years and passive smoker were equal (40 py; 37% passive). 34% in both groups had family history of lung cancer. Non-small cell lung cancer was significantly more frequent in elderly group. Stage IV prevailed In both groups (62-63%). Most younger patients received third (14% vs 6%, p b 0,001) and forth lines for metastatic disease (6% vs 1,4% p b 0,001). At last follow up; 44% younger versus 52% elderly had died (p:0,001). Overall survival: 24,7 months versus 19.4 p:0.003. Analysis survival by prognostic factors shown differences in survival for groups ages by stages (best for younger)
Keywords: Lung doi:10.1016/j.jgo.2013.09.036
Track 1 - Solid Tumours in the Elderly Lung cancer in eldery patients P033 Post ablation chemotherapy improves outcomes following percutaneous radiofrequency ablation for local control of solid lung tumors in elderly patients P. Andrew1,*, S. O'Connor2, S. Jerat3, R. Lee-Ying4. 1Department of Internal Medicine, The Ottawa Hospitals, Ottawa, Canada; 2City University, London, United Kingdom; 3ATLAS Medical Research Inc., Edmonton; 4Department of Medical Oncology, Tom Baker Cancer Centre, Calgary, Canada Introduction: With a burgeoning population of elderly patients with lung cancer deemed non-surgical, increasing utilization of minimallyinvasive, safe, repeatable, tissue-preserving techniques such as percutaneous radiofrequency ablation (RFA) is occurring for the management of solid tumors. However, it is unknown whether a strategy of RFA plus post ablation chemotherapy (PAC) improves locoregional and survival outcomes in aged patients. Objectives: We compared local tumor recurrence and survival outcomes of RFA plus PAC versus RFA alone for management of primary and metastatic solid lung tumors in non-surgical patients. Methods: Searched PubMed, the Cochrane Library, EMBASE, and CANCERLIT databases from January 2000 to December 2012. Blinded duplicate screening for data extraction. Population was deemed nonsurgical, with solid lung tumors, both primary and/or metastatic. Generated aggregate effect estimates from constituent studies for three outcomes (e.g., local tumor progression [LTP], overall survival [OS], and disease-free survival [DFS]) with comparison of pooled fixed effect analyses concerning RFA plus PAC versus RFA alone. Results: RFA plus PAC group versus RFA alone group: LTP of 15% over median follow-up of 31 months [range 12 to 59] versus 19% over median follow-up of 21 months [range 12 to 29]; odds ratio (OR) 0.73 (95% CI: 0.61-0.86, p b 0.05) at 12 month follow-up. OS was 89% versus 78%, respectively, at 12 month follow-up; OR 1.52 (95% CI: 1.16-2.00, p = 0.003). DFS was 90% versus 82%, respectively, at 12 month follow-up; OR 3.18 (95% CI: 2.04-4.96, p b 0.05). Forrest plots for the outcomes of LTP, OS, and DFS are shown. Sensitivity analyses were robust, publication bias relatively narrow, and Q statistic b21; p N 0.13 for all outcomes. Image:
S39
Conclusion: A strategy of RFA plus PAC retards LTP, but lengthens both OS and DFS. Elderly patients most likely to benefit from this strategy would be non-surgical candidates with relatively good performance status who could tolerate both RFA and PAC. Disclosure of Interest: None Declared Keywords: Lung, Translational research doi:10.1016/j.jgo.2013.09.037
Track 1 - Solid Tumours in the Elderly Lung cancer in eldery patients P034 Lung cancer in women: Do tumors behave differently in the elderly? A prospective comparison of World07 data base R. Gironés1,* on behalf of ICAPEM, M. Provencio2 on behalf of ICAPEM, M. Majem3 on behalf of ICAPEM, P. Garrido4 on behalf of ICAPEM, E. Felip5 on behalf of ICAPEM, E. Felip5 on behalf of ICAPEM, N. Viñolas6 on behalf of ICAPEM, A. Artal7 on behalf of ICAPEM, L. Isla8 on behalf of ICAPEM, E. Carcereny9 on behalf of ICAPEM, C. García-Campelo10 on behalf of ICAPEM, P. Lianes11 on behalf of ICAPEM, R. De las Peñas12 on behalf of ICAPEM and ICAPEM: Asociación para la investigación de cáncer de pulmón en mujeres. 1Medical Oncology, Hospital Lluis Alcanyis, Xàtiva; 2 Medical Oncology, Hospital Puerta del Hierro, Madrid; 3Medical Oncology, Hospital Sant Pau, Barcelona; 4Medical Oncology, Hospital Ramón y Cajal, Madrid; 5Medical Oncology, Hospital Vall d'Hebron; 6 Medical Oncology, Hospital Clinic, Barcelona; 7Medical Oncology, Hospital Miguel Servet; 8Medical Oncology, Hospital Lozano Blesa, Zaragoza; 9Medical Oncology, Hospital Germans Trias i Pujol, Badalona; 10 Medical Oncology, Complexo Hospital A Coruña, Coruña; 11Medical Oncology, Hospital de Mataró, Barcelona; 12Medical Oncology, Hospital de Castellón, Castellón, Spain1On behalf of ICAPEM.2ICAPEM: Asociación para la investigación de cáncer de pulmón en mujeres. Introduction: Lung cancer appears to behave differently in women.Women are more likely to present with adenocarcinoma, diagnosed at localized disease and have better survival(1).It's unclear, however, whether elderly lung cancer women had a different natural history than younger Objectives: To investigate differences in epidemiology,types of presentation,tumor characteristics,treatment and survival between younger and older women with lung cancer included in a prospective Spanish multicenter registry Methods: Wolrd07 is an epidemiological multicentre prospective registration of women with lung cancer attended at Spanish institutions. From October 2007 to October 2012. Last follow up:April 2013. Clinicopathologic and tumor information was prospectively collected and compared between age groups. Survival was determined as the interval form the date of cancer diagnosis to the date of death. The institution’s ethical review board approved this study. All of the patients provided written informed consent Results: 38 institutions registered 2081 patients. Patient’s characteristics are reported in table. Caucasian race (98%,p:0,899). Some hormonal factors shown statistical differences; however number of children was similar (median: 2; 0-10). Smoking habits differ from both groups. Median pack years and passive smoker were equal (40 py; 37% passive). 34% in both groups had family history of lung cancer. Non-small cell lung cancer was significantly more frequent in elderly group. Stage IV prevailed In both groups (62-63%). Most younger patients received third (14% vs 6%, p b 0,001) and forth lines for metastatic disease (6% vs 1,4% p b 0,001). At last follow up; 44% younger versus 52% elderly had died (p:0,001). Overall survival: 24,7 months versus 19.4 p:0.003. Analysis survival by prognostic factors shown differences in survival for groups ages by stages (best for younger)