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O. Lebedieva
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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
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.08-029 - Combination Treatment of Intrathoracic Esofageal Cancer (ID 3018)
09:30 - 17:00 | Author(s): O. Lebedieva
- Abstract
Background:
Introduction. Esophageal cancer (EC) is the sixth most common cause of death in cancer patients in the world. EC is classified into squamous cell carcinoma (80%) and adenocarcinoma (20%). Squamous EC is more sensitive to chemoradiotherapy (CRT) than adenocarcinoma, but long-term results of their treatment are similar. Combination therapy is used for EC treatment due to poor overall survival performance in patients who received only surgical treatment. Neoadjuvant CRT followed by surgical treatment is the most common treatment paradigm in patients with resectable EC. According to results of meta-analyses, neoadjuvant CRT in combination with surgical treatment significantly improves 3-year survival and reduces the incidence of local recurrence in comparison with surgery alone. Objective. To study and compare short-term results of treatment in patients with EC using intravenous and intra-arterial neoadjuvant CRT.
Methods:
using intravenous and intra-arterial neoadjuvant CRT. Materials and methods. 54 patients with verified squamous EC of intrathoracic esophagus (T2-3N0-1M0) were enrolled into the study and randomized into two groups. Group I patients (n = 26) received neoadjuvant CRT with intra-arterial injection, while group II patients (n = 28) - intravenous CRT. In accordance with standards, chemotherapy, radiotherapy and surgery were performed. Operation was performed 2-3 weeks after CRT.
Results:
Therapeutic pathomorphism was detected in 75% of group I patients and in 81% of group II patients. Complete tumour regression occurred in 4% and 11%, partial regression - in 73% and 68%, stabilization process - in 4% and 7%, and progression of the disease was observed in 19% and 14% of patients in groups I and II, respectively.
Conclusion:
Tumour response to neoadjuvant treatment is evident in both groups. Short-term results of treatment demonstrate no advantages of intra-arterial chemotherapy, which is economically unjustified compared to intravenous chemotherapy. The ultimate conclusions regarding the advisability of intra-arterial neoadjuvant CRT injection of drugs in patients with intrathoracic esophageal cancer may be drawn after studying of the long-term results.
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-022 - Pulmonary Resection of Metastatic Renal Cell Carcinoma (ID 3043)
09:30 - 17:00 | Author(s): O. Lebedieva
- Abstract
Background:
Pulmonary resection for metastases from renal cell carcinoma (mRCC) is a treatment option that can provide long-term disease-free survival. Larger number and size of metastatic nodules, increasing number of lymph node metastases, shorter disease-free interval, and decreased preoperative forced vital capacity are negative prognostic factors in this setting. The potential role of surgery is illustrated by the results from a series of 278 patients with mRCC in which 51 percent underwent removal of all of their metastatic disease with curative intent, 25 percent underwent partial resection of their metastatic disease, and 24 percent were treated without surgery. Metastases were most frequently resected from the lung, brain, bone and soft tissue.
Methods:
Between 1989 and 2014, 73 patients (44 men, 29 women) underwent pulmonary resection of mRCC. Only patients who met the criteria for potentially curative operation, that means, control of primary tumor, ability to resect metastatic diseas were included. All patients received immunotherapy after surgical treatment.
Results:
Pulmonary metastases were bilateral in 15 patients and unilateral in 58 patients. 15 bilateral (9 staged) and 58 unilateral thoracotomies were performed. Wedge resection was performed in 68 and lobectomy in 5 patients. The overall 5-year survival was 72.8 % 10-year survival was 43,9% and 15-year survival was 20,9% among the patients, who had no other extrapulmonary metastases. The 5-year survival of curative resected patients with metachronous metastases was better then patiens with synchronous metastases. The overall 5-year survival was 31,3 % among the patients, who had extrapulmonary metastases.
Conclusion:
Surgical resection of isolated lung metastases in carefully selected patients is safe and effective. Metastasectomy nowadays is the best treatment option in cases with technical resectable metastases with as much as possible good prognostic factors.
