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V. Barmin



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    P1.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 224)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
    • Presentations: 1
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      P1.08-019 - Pure Bronchoplasty without Lung Parenchyma Resection for Central Carcinoid (ID 311)

      09:30 - 17:00  |  Author(s): V. Barmin

      • Abstract
      • Slides

      Background:
      The aim of the study is to evaluate the efficacy of combined approach (endoscopic resection followed by pure bronchoplasty without any pulmonary resection) in patients with endobronchial carcinoids.

      Methods:
      We applied two-staged technique (endoscopic resection first followed by pure bronchoplasty) to 25 patients (males – 10) with endobronchial carcinoid. The median age was 32,4 years with a range from 19 to 64 years. The indications to this technique were pure endobronchial carcinoid without lymph node involvement. Tumour was located on the right side in 18 (72%), on the left – in 7(28%) patients. Endoscopic resection/desobliteraton of central airway was performed to all patients as the first stage procedure to resolve the obstructive pneumonia and to localize the pedicle of the tumour for proper planning of further bronchoplasty followed by endobronchial ultrasound to detect the peribronchial component. Different types of pure bronchoplasty were performed as the second stage surgery with systematic mediastinal lymph node dissection (table 1). Table 1.Types of bronchial sleeve resections in our series

      type of resection right side left side
      main stem bronchus 7 5
      bronchus intermedius 7 -
      main stem bronchus+upper lobe bronchus 2 2
      bronchus intermedius+middle lobe bronchus 1 -
      bronchus intermedius+lower lobe bronchus 1 -
      Total 18(5)* 7(2)*
      * polybronchial anastomosis was performed


      Results:
      The resection was complete (R0) in all cases. No lymph node metastases were observed, and tumours were pathologically staged as pT1aN0 in 18, pT2N0 – in 5, pT3N0 – in 2 patients and that all cases had invasive components limited to the bronchial wall. Twenty three tumours were typical and only two - atypical carcinoids. Morbidity was 33,3% (only minor complications) with no mortality. The stenosis of bronchial anastomosis was observed in one patient treated by endoscopic intervention. Overall 5- and 10-years survival was 100,0% and 96,0% (one patient died from myocardial infarction 8 years after surgery). No recurrence of the primary tumour was observed in any case.

      Conclusion:
      Two-staged surgery (endoscopic resection+pure bronchoplasty without lung parenchyma resection) is an effective technique for treatment of endobronchial carcinoids with excellent oncologic outcome.

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    P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P3.03-019 - Salvage Surgery after Definitive Chemoradiotherapy in NSCLC Patients (ID 304)

      09:30 - 17:00  |  Author(s): V. Barmin

      • Abstract
      • Slides

      Background:
      The benefits of salvage resection for lung cancer recurrence following high-dose curative-intent chemoradiation therapy are unclear. The study was aimed to assess postoperative morbidity and survival after salvage lung resection following definitive chemoradiation.

      Methods:
      In this retrospective study, medical records of 14 patients undergoing lung cancer resections at our institution following definitive chemoradiation therapy were reviewed from June 2008 to December 2013. There were 10 (71,4%) males and 4 (28,6%) females, median age - 52,6 years. The most common histologic type of lung cancer was squamous cell carcinoma (64,3%). Pretreatment lung cancer stage was IIB - in 2, IIIA - in 11 and IIIB - in one patient. Definitive radiation treatment varied from 45 to 70 Gy (median - 58Gy). Mean number of chemotherapy cycles was 3,8 per patient. Surgery included pneumonectomy in all patients, except one, whom left-lower lobectomy was performed. In all cases bronchial stump was reinforced with a pedicled muscle flap. Postoperative complications were registered according to the Thoracic Morbidity and Mortality System (TMM).

      Results:
      Postoperative complications were registered in 7 (50,0%) patients: grade II complications were detected in 2, grade IIIA – in 1, grade IVA – in 3 and grade V (mortality) – in one patient (7,1%). Pathologic stage was IB – in 2, IIA – in 1, IIB – in 5, IIIA – in 4 and IIIB – in 2 patients. Overall 1, 2 and 3-year survival was 89,1%, 82,0% and 48,0% with median survival 35 months. Disease-free 1, 2 and 3-year survival was 84,2%, 72,0% and 24,8% respectively, median – 28 months. Overall and recurrence-free 5-year survival was 10,8%. Recurrence in the chest was diagnosed in one patient, distant relapse – in 6. No variables were found to be associated with improved post-chemoradiation survival from the time of definitive treatment or postoperative survival.

      Conclusion:
      Salvage lung resection for recurrent lung cancer following definitive chemoradiation therapy is feasible and is associated with postoperative survival and complication rates that are reasonable.

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