Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
study drug cost. However, other medical costs during the concurrent phase
were lower for PemCis due to significantly lower hospitalization costs and
lower concomitant medications use. When adjusting for overall treatment
duration, other medical costs were favorable for PemCis. Pemetrexed
patients may incur lower monthly other medical costs due to reduced
hospitalization costs.
Keywords: pemetrexed, non-small cell lung cancer, locally advanced,
economics
POSTER SESSION 2 – P2.02: LOCALLY ADVANCED NSCLC
CLINICAL OUTCOME –
TUESDAY, DECEMBER 6, 2016
P2.02-014 PERIOPERATIVE OUTCOMES AND DOWNSTAGING
FOLLOWING NEOADJUVANT THERAPY FOR LUNG CANCER –
ANALYSIS OF THE NATIONAL CANCER DATABASE
Scott Atay 1 , Jiangong Niu 2 , Sharon Giordano 2 , Mara Antonoff 1 , John Heymach 3 ,
Wayne Hofstetter 1 , Reza Mehran 1 , David Rice 1 , Jack Roth 1 , Ara Vaporciyan 1 ,
Garrett Walsh 1 , William William Jr 1 , Stephen Swisher 1 , Boris Sepesi 1
1 Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, Houston/
TX/United States of America, 2 University of Texas, MD Anderson Cancer Center,
Houston/TX/United States of America, 3 Thoracic Head and Neck Medical Oncology,
The University of Texas MD Anderson Cancer Center, Houston/TX/United States of
America
Background: Administration of chemotherapy prior to surgical resection is
one of the strategies for the treatment of locally advanced non-small cell
lung cancer (NSCLC). Potential benefits of this approach include improved
treatment tolerance, tumor downstaging, and the evaluation of tumor
response. Utilizing the National Cancer Database (NCDB), we sought to
compare short-term perioperative outcomes and treatment response
of neoadjuvant chemotherapy followed by surgery with surgery alone.
Methods: We queried the NCDB Participant User File (PUF) for patients with
clinical stage IB-IIIA NSCLC who underwent definitive surgical resection for
NSCLC between 2006-2013. We identified 83,274 patients with complete
datasets who met the inclusion criteria. Patients were grouped by stage and
perioperative outcomes were assessed, comparing those who underwent
neoadjuvant therapy to surgery alone. Neoadjuvant therapy response was
assessed by downstaging on final pathology in both unmatched and matched
cohorts. Results: Neoadjuvant chemotherapy was administered to 11.9%
(9,961/83,274) of potentially eligible patients. The incidence of neoadjuvant
therapy increased with clinical stage; rates of 2.7% (995/37,453) for IB, 5.4%
(724/13,435) for IIA, 15% (2,048/13,619) for IIB, and 33% (6,194/18,767) for
IIIA. All cause 30-, and 90-day mortality was 3.1% and 6.3% vs. 3.1% and 6.0%
for neoadjuvant vs. surgery alone across all stages, (p=0.159, p