A. Chowdhury

Comparison of 7th and 8th editions of the UICC/AJCC TNM staging for non-small cell lung cancer in a non-metastatic North American cohort undergoing primary radiation treatment

BACKGROUND We compared the performance of 7th and 8th edition of the Union for International Cancer Control (UICC) / American Joint Committee on Cancer (AJCC) TNM staging for non-small cell lung cancer (NSCLC) in non-metastatic (stage I-III) North American cohort undergoing primary radiation treatment. METHODS Newly diagnosed NSCLC between (Jan 2011 - Dec 2014) were screened through a Canadian Provincial Cancer Registry. Clinico-radiologically and pathologically confirmed non-metastatic NSCLC undergoing primary radiation treatment were included. Kaplan-Meier methods, Cox proportional hazard regression and Akaike information criterion (AIC) were applied to evaluate discriminatory ability and prognostic performance of 7th and 8th edition of staging systems. RESULTS In this cohort of 295 patients, 8th edition stages IA3, IB, IIA, IIB, IIIA, IIIB, and IIIC showed progressive increase in the hazard ratio compared to best stage IA2 (8th edition IA3 vs IA2: HR 1.72; IB vs IA2: HR 2.04; IIA vs IA2: HR 2.66; IIB vs IA2: HR 2.91; IIIA vs IA2: HR 3.38; IIIB vs IA2: HR 3.62 and IIIC vs IA2: HR 8.22). In a multivariate model, 8th edition stage grouping had smaller AIC of 2342.08 compared to 7th edition 2349.55, confirming better performance. International Association for the Study of Lung Cancer (IASLC) map based nodal categorization N1, N2 and N3, showed good survival and hazard discrimination over stage N0 (1.39, 1.48 and 2.16 respectively). CONCLUSION In an independent cohort of non-metastatic NSCLC undergoing primary radiation treatment, improved performance of 8th edition UICC/AJCC staging system over 7th edition was observed.

203 Permanent radioiodine seed implant in clinically localized prostate cancer: Preliminary results of first 12 months of experience at Cancer Care Manitoba

look for a possible relationship between pre-treatment risk factors, including the International Prostate Symptom (IPS) score, urinary flow studies, and post-treatment urinary toxicity. Methods: Data on 215 patients undergoing brachytherapy was reviewed. All patients had pre-treatment IPS scores and urinary flow studies. The relationship between these scores and acute urinary toxicity, as indicated by post-treatment catheterization, was evaluated. Results: Mean patient age was 64 years, mean baseline IPS score was 9, and mean prostate volume was 38 cc. 12% had prior hormone therapy to downsize the prostate. 18% required insertion of a urinary catheter at any time after the brachytherapy procedure. There is an inverse relationship between the baseline IPS score and peak flow rate (PFR). PFR score for those patients requiring a catheter post-treatment was less than for those not requiring a catheter. Using a univariate logistic regression model, total IPS score was not a predictor of retention (p-value=0.85), nor was age, volume voided or post void residual; however, prostate volume (p<0.001), prior hormones (p<0.001) and PFR were predictive (p=0.011). For every 10-unit increase in PFR, the odds of catheterization decreased by 54% (e.g. 1-0.46) (95% confidence interval 0.25-0.84). In multivariate analysis, only prostate volume (p=0.005) and peak flow rate (p=0.003) were predictive. Conclusions: For patients undergoing treatment with I 125 brachytherapy for early stage prostate cancer, the pretreatment IPS questionnaire and urinary flow studies can assist in predicting who will be at increased risk of urinary toxicity and urinary retention post brachytherapy.