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T. Grodzki



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    MO11 - Screening and Epidemiology (ID 131)

    • Event: WCLC 2013
    • Type: Mini Oral Abstract Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      MO11.13 - Low selenium serum level is a good preselection factor for patients invited for low dose chest CT lung cancer screening (ID 823)

      16:15 - 17:45  |  Author(s): T. Grodzki

      • Abstract
      • Presentation
      • Slides

      Background
      Selenium is known as a chemoprotective anti-cancer agent. The impact of low selenium serum level on the frequency of early lung cancer (LC) detection rate in patients participating in a low dose chest CT (LDCT) screening program is assessed.

      Methods
      A program of early LC detection was conducted in a single city of 400000 inhabitants from 2008 till 2011 (Protocol I). Enrollment criteria included both sexes aged 55-65 years with a history of 20 pack-years of tobacco smoking. All detected lesions were followed up in accordance with IELCAP protocols. A new pilot study (Protocol II) launched in 2012 was based on preselection of the participants by measure of their selenium serum level. Only individuals with a low selenium level (< 75 microgramms/ml) were invited for CT scans. Other enrollment criteria were the same as in Protocol I. All cases requiring surgery were referred to a single local thoracic surgery department. The following data were analyzed: number of all detected lesions as well as LC detected in both protocols.

      Results
      Protocol I: 15020 patients were screened by LDCT. 6240 pulmonary lesions were detected with the majority (59%) smaller than 5mm. 182 patients (2.9% of all detected lesions) were referred for thoracic surgery. 119 primary LC were diagnosed and treated. Protocol II: 2440 patients have had selenium serum level measured. 720 of them were screened by LDCT. 210 lesions were detected with 49% smaller than 5mm. 14 patients (6.8%) were referred for thoracic surgery. 9 primary LC were diagnosed and treated surgically. Protocol II was more specific because number of all detected lesions was significantly smaller than in Protocol I (p < 0.0001, OR: 0.55; CI: 0.46 – 0.64) but the LC detection rate in Protocol II was more than twice as high as in Protocol I (p = 0.0226, OR: 2.38; CI: 1.19 – 4.76).

      Conclusion
      The detection rate of LC in the program of early detection based on LDCT is higher if the protocol is supported by preselection of high risk tobacco - smoking patients based on a low level of selenium in serum.

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    P1.20 - Poster Session 1 - Early Detection and Screening (ID 172)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      P1.20-001 - Early lung cancer detection programme - its impact on activity of the local thoracic surgery department (ID 74)

      09:30 - 16:30  |  Author(s): T. Grodzki

      • Abstract

      Background
      The impact of massive early lung cancer detection program on patients` profile and surgical activity of the local thoracic surgery department is analyzed.

      Methods
      Early lung cancer detection program was conducted in a single city of 400000 inhabitants from 2008 till 2011. Enrollment criteria included both sexes aged 55-65 years with history of 20 pack-years of tobacco smoking. All detected lesions were followed up in accordance with IELCAP protocols. All cases requiring surgery were referred to a single local thoracic surgery department serving for the population of appr. 2 million people. Following data were analyzed: number of NSCLC detected and resected, number of stage I resected patients, histology, type of surgery.

      Results
      15020 patients were screened (39.5% of the population of people aged 55-65 in our city). 6240 pulmonary lesions were detected, majority (59%) smaller than 5mm. 445 lesions (7.1%) were bigger than 15mm. 182 patients (2.9% of all detected lesions) were referred to the local thoracic surgery. Overall 925 NSCLC were resected at our department in 2008-2011. 232 (25%) of them were stage I. Number of pneumonectomies was 166 (18%). Dominant histology was squamous cell (52%) 247 metastatic lesions were resected in the same period. The early detection group delivered 77 NSCLC resections (8.3% of all resections). 53/77 (69%) were stage I (significant difference versus the entire group). Number of pneumonectomies was 2/77 (2.5%, significant difference vs entire group). Dominant histology was adenoca (50%). 33 metastatic lesions (13.3% of all metastases resections) were treated surgically. 15 small cell lung cancer were diagnosed and referred for chemotherapy. 33 metastatic lesions were resected, too.

      Conclusion
      The patients with NSCLC detected by the early lung cancer detection programme are treated surgically in earlier stages in comparison to the entire population of patients referred to our department. They require pneumonectomy significantly less frequently than the entire group.

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    P3.20 - Poster Session 3 - Early Detection and Screening (ID 174)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      P3.20-002 - First low dose chest CT lung cancer screening programs in Poland - overall results (ID 928)

      09:30 - 16:30  |  Author(s): T. Grodzki

      • Abstract

      Background
      To present results of the first four lung cancer (LC) screening programs based on low dose chest CT (LDCT) conducted in Poland.

      Methods
      Four LC screening programs were conducted in different Polish cities (Gdansk, Poznan, Szczecin, Warsaw) between 2008 and 2011. Algorithms used for patient`s selection for further diagnostics were based on IELCAP protocols with local modifications. The enrolled patients were ages 50-75, being either active smokers or with history of >20 pack years. The following data were analyzed: number of LC detected and resected in both protocols, and percentage of stage I cancers detected.

      Results
      34810 patients were screened in accordance with protocols. Results are presented in table I.

      Parameter G P W Sz All
      N[o ]of patients 8693 9357 1740 15020 34810
      LC detected 91 96 17 120 324
      LC stage I 58 52 12 83 205
      The overall detection rate was 1 cancer per 102 CTs and varied from 1/125 to 1/90 (1.05%, 1.03%, 1.0%, 0.86%, 0.98% respectively). The majority of cancers were diagnosed in stage I (64%, 55%, 70%, 69% 64.5% respectively), while this parameter does not exceed 30% in overall population treated by thoracic surgery in Poland. The differences between centers regarding both detection rate and stage I percentage were not significant (p=0.167 and p=0.599 respectively). However, if one compares the biggest center alone (Szczecin) vs all other ones together, the detection rate in Szczecin is significantly lower (p=0.0278).

      Conclusion
      The detection rate of all LC as well as stage I LC in the Polish LDCT screening programs is high and comparable in different centers.