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I. Inci



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    OA22 - Novel Trials and Biomarkers in Malignant Pleural Mesothelioma (ID 403)

    • Event: WCLC 2016
    • Type: Oral Session
    • Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
    • Presentations: 1
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      OA22.07 - Correlation of CT Scan Based Tumor Volume Measurement to Actual Resected Tumor Volume - A New T-Factor? (ID 5958)

      14:20 - 15:50  |  Author(s): I. Inci

      • Abstract
      • Presentation
      • Slides

      Background:
      Tumor volume has been reported to be a valuable prognosticator for malignant pleural mesothelioma (MPM) survival. We wanted to assess the precision of CT scan based preoperatively measured tumor volume when correlated to the actual resected tumor weight and tumor volume after pleurectomy/decortication.

      Methods:
      From 10/2012 – 06/2016 the tumor weight of surgery specimens was measured in 32 patients undergoing macroscopic complete resection by (extended) pleurectomy/decortication ((e)P/D). The median tumor weight of all patients was (n=32) 443g (95-783g). In all patients tumor volume was measured in the CT or PET-CT scans performed before surgery as described previously (Frauenfelder 2011). Tumor volume of the resected specimen was additionally measured in 21 patients. Relations between tumor weight, tumor volume at surgery, CT-volume, cT stage and pT stage were analyzed using Spearman rank correlation.

      Results:
      Median time between CT scan and surgery was 18 days (range 1-48). The analysis revealed a moderate correlation between CT tumor volume and weight (p=0.001, correlation coefficient 0.58, CT volume and tumor volume at surgery showed strong correlation (p=0.001, correlation coefficient 0.65). No significant correlation was observed between cT stage and tumor weight (p=0.1, correlation coefficient 0.31), but a moderate correlation between cT stage and CT volume (p=0.001, correlation coefficient 0.58) as well as specimen volume (p=0.008, correlation coefficient 0.58). There was a moderate correlation of tumor weight with pT stage (p=0.02, correlation coefficient 0.42), but no correlation of CT volume (p=0.1, correlation coefficient 0.31) as well as specimen volume with the pT stage (p=0.2, correlation coefficient 0.32). Figure 1



      Conclusion:
      The correlation between preoperatively assessed CT tumor volume and volume of the resected specimen showed a strong correlation. To assess the prognostic role of CT measured tumor volume a correlation to prognosis has to be performed before implementation as a new T-factor.

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    P2.04 - Poster Session with Presenters Present (ID 466)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
    • Presentations: 1
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      P2.04-029 - Primary Pulmonary Sarcoma: Risks and Optimal Surgical Treatment Options (ID 5652)

      14:30 - 15:45  |  Author(s): I. Inci

      • Abstract
      • Slides

      Background:
      Primary pulmonary sarcoma (PPS) is a rare tumor among malignant lung neoplasms. We aimed to clarify the clinical characteristics and therapeutic outcomes of patients who underwent surgical resection for PPS and to discuss beneficial treatment and surgical options.

      Methods:
      We retrospectively reviewed the records of those who underwent surgical resection for primary pulmonary sarcoma in our institution between 1995 and 2014. Cases only with biopsy were excluded.

      Results:
      Twenty four patients were analyzed. Eighteen were male. Their ages ranged from 18 to 83 years (mean 57). Surgical procedures were pneumonectomy in 10, lobectomy in 11 and wedge resection in 3. Complete resection was achieved in 14. Pathological stage based on the 7th lung cancer TNM classification were stage I in 4, II in 12, III in 2, and IV in 5. Four patients had metastasis in lymph nodes. The pathological grades were G1 in 4, G2 in 5 and G3 in 15. Five patients had postoperative complications. Tumor recurrence was observed in 5. During the observation 12 patients died. 5-year overall survival was 50.1%. Adverse prognostic factors for overall survival were detected as (p=0.001), incomplete resection (p=0.014), advanced pathological stage (p=0.001), higher pathological grade (p=0.028), and tumor size more than 7cm (p=0.044).

      Conclusion:
      Our series of primary pulmonary sarcoma revealed that pneumonectomy, incomplete resection, advanced pathological stage, higher pathological grade, and tumor size were unfavorable factors for long survival. Although complete resection is essential for primary pulmonary sarcoma due to its poor prognosis, it is recommended to avoid pneumonectomy, if possible, and to consider conservative surgical approaches including sleeve lobectomy.

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