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F. Caushi



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    P1.01 - Poster Session with Presenters Present (ID 453)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Epidemiology/Tobacco Control and Cessation/Prevention
    • Presentations: 1
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      P1.01-009 - Smoking and Lung Cancer: Data from the Single Center in Albania (ID 4128)

      14:30 - 15:45  |  Author(s): F. Caushi

      • Abstract
      • Slides

      Background:
      Albania is a country with a high prevalence of smoking but a national cancer registry has not been initiated yet and data on lung cancer are scarce.

      Methods:
      Aim - Methods: In 2010-2014, 1254 patients presented to our hospital with either symptoms or an abnormal finding in their chest X-ray and were diagnosed with lung cancer. This is a descriptive retrospective study, reporting data on the histological type of cancer and smoking history

      Results:
      Results: Of the 1254 patients, 79% (n= 1001) were men and 21% (n=253) women . Age range was (16-89), with mean age in men 62.4 ±8,5 and in women 58±10,2. Diagnosis was confirmed by histology [table 1] : Regarding NSCLC, 78% of patients had an advanced stage (III and IV). Only 268 patients were non-smokers, 126 were ex-smokers and the remaining 67 % (n=860) were current smokers with high exposure (92 pack/years). Day hospital avarage is 7 day,and day range was(1-21) with SD± 6.4. Performance status was:60.2% improved,35.2% idem,3.3% dead in hospital.

      Squamous cell carcinoma Adenocarcinoma Small cell others Total
      men 56%(n=560) 22%(n=220) 15%(n=150) 7%(n=71) 100%(n=1001)
      women 11%(n=27) 72%(n=183) 5%(n=13) 12%(n=30) 100%(n=253)


      Conclusion:
      In Albania,lung cancer is an increasing pathology (p<0.005) and there is a high prevalence of squamous cell carcinoma especially in men,probably associated with the heavy history of smoking and most patients are diagnosed at a late stage.Policies for smoking cessation should be strengthened and a lung cancer screening program should be initiated.

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    P1.04 - Poster Session with Presenters Present (ID 456)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Pulmonology
    • Presentations: 2
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      P1.04-006 - Second Primary Lung Cancer: Five Years of a Single Center Experience in Its Diagnosis and Treatment (ID 4626)

      14:30 - 15:45  |  Author(s): F. Caushi

      • Abstract
      • Slides

      Background:
      Second primary lung cancer (SPLC) constitute an important dimension of the burden of cancer survivorship that needs to be taken into account when defining strategies for surveillance, prevention and counseling. In last three decades the incidence of SPLC in patients that had a history of a prior cancer out of the respiratory system is estimated 2-8%. Relative risks of SPLC may be smaller than previously reported may benefit from increased surveillance. The goal of this study was to give an overview of SPLC regarding patients’ primary malignancy, their stage of lung cancer presentation and bringing to the light some possible risk factors. Such data will be helpful in calculation of the risk for SPLC as well as handling of risky patients for a better survival.

      Methods:
      This is a retrospective study for a period of 5 years where all the data that was gathered from clinical cartels of patients with lung cancer were analyzed using Pearson Chi-Square.

      Results:
      SPLC represents 2% of all lung cancers diagnosed during the period of study. The prior diagnose of cancer for this patients was breast cancer in 46% of cases, cervix cancer in 40% of cases and the other diagnosis 14% of cases. All the patients have been under oncologic treatment with radio or chemotherapy. 20% of these patients have been smokers prior to first malignancy. The average age of the patients with SPLC was 55 years old. The ratio male to female was 1:10. The most frequent hystotipe found was adenocarcinoma in 60% of cases meanwhile in all cases with a prior squamous cell cancer of cervix was found squamous cell carcinoma as SPLC. The average period of time from the prime cancer to the SPLC was 3.7 years. 73% of cases with SPLC underwent an anatomical resection of the tumor.

      Conclusion:
      This study shows that patients with the higher risk for a SPLC are premenopausal women with breast cancer and cervical cancer. Changes in the prevalence of risk factors and diagnostic techniques may have affected more recent risks. The relative risk of developing SPLC in smokers is unclear. SPLC after oncologic treatment is an issue that raises many questions.

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      P1.04-020 - Management of Lung Cancer in Patients with past Pulmonary Tuberculosis and Their Possible Causative Link (ID 4170)

      14:30 - 15:45  |  Author(s): F. Caushi

      • Abstract
      • Slides

      Background:
      Lung cancer and tuberculosis cause significant morbidity and mortality worldwide. In the past, it was well known that lung cancer is a specific epidemiological successor of pulmonary tuberculosis (PTB) and that it often develops in scars caused by PTB. In recent years, the relevance of the two diseases has drawn attention in terms of the close epidemiological connection and chronic inflammation-associated carcinogenesis. Although studies have found a relationship between PTB and lung cancer, results for the long-term risk and the role of confounding factors remain inconclusive. Therefore, it is important to delineate the relationship between PTB and lung cancer.

      Methods:
      Clinical files of all patients diagnosed with lung malignancy between 2011 and 2016 were investigated retrospectively in terms of patient characteristics, definite histopathological diagnosis and stage of tumor, operation methods, and associated complications.

      Results:
      Mean age was 56.4 years. Past PTB was detected in 3% of operated carcinoma patients and in 6% of all patients diagnosed with lung malignancy. Central lung cancer was diagnosed in 80% of cases and peripheral in 20%. Epidermoid cancer was diagnosed in 51% of cases, adenocarcinoma in 24% and adenoepidermoid carcinoma in 25%. All cases of operable lung cancers were in stage I and II, while inoperable lung cancers were in stage IIIB and IV. Lobectomy was performed in 100% of the operated cases. None of the patients received anti-TB treatment preoperatively or postoperatively because by the time they were diagnosed with lung cancer, their sputum culture for M.Tuberculosis had converted negative. No postoperative mortality or reactivation of TB was seen.

      Conclusion:
      PTB is an important risk factor for lung cancer, possibly related to chronic inflammation and shared risk factors. Our study adds to the evidence that implicates chronic inflammation and pulmonary scarring in the etiology of lung cancer. However, further studies are needed to clarify whether there is a direct causative link between PTB and lung cancer. Surgery is the method of choice in treatment of lung cancer in subjects with past PTB history.

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    P1.08 - Poster Session with Presenters Present (ID 460)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P1.08-030 - Female Lung Cancer and Our Five Year Experience (ID 4627)

      14:30 - 15:45  |  Author(s): F. Caushi

      • Abstract
      • Slides

      Background:
      Lung cancer is one of the leading causes of mortality in the world. The incidence of lung cancer in females is increasing, in contrast to that seen in males. However, according to a lot of publications, lung cancer is almost six times more frequent in men than in women. The literature shows clearly that lung cancer in women differs from that in men in several aspects and environmental factors and lifestyle plays an important role in the female lung carcinogenesis. The objectives of this study were to evaluate clinic-morphologic features of lung cancer in women and the role of the surgery in their treatment.

      Methods:
      This was a descriptive retrospective study, conducted for five years. We analyzed all patients hospitalized diagnosed and treated for lung cancer and using Pearson Chi-Square test.

      Results:
      The ratio men to women for patients diagnosed with lung cancer was 8 to1.The most common histotype was Adenocarcinoma 76%, Squamous cell carcinoma 11%, Small cell carcinoma 5%, others 8%.The average age was 57.5 with SD±12 years. 6% of females were in I stage, 22% of them were in II stage, 15% of them were in IIIA stage, 10% of them in IIIB stage and 47% in IV stage. Only 9% of our patients were smokers. Dyspnea was the main clinical sign, found in 67% of women. The standardized incidence of female lung cancer patients was 5/100.000. The surgery was performed in 20% of them meanwhile in men it was performed in 12.5% of cases.

      Conclusion:
      Most of women diagnosed with lung cancer were in advanced stages. Adenocarcinoma is the common histotype. This study shows that lung cancer in female is eight time less frequent in women than in men. Since the ratio men to women regarding to being operable is in the favor of women because they are diagnosed earlier comparing to men, women are more subject of surgery. Because the clinical signs of lung cancer are far from being specific, a substantial portion of lung cancer cases and deaths could be prevented by applying effective prevention measures, such as tobacco control and the use of early detection tests.

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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: 2
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      P2.04-044 - Mediastinal Neurogenic Tumors: Histopathological Characteristics and Surgical Treatment in a Single-Institutional Experience (ID 4169)

      14:30 - 15:45  |  Author(s): F. Caushi

      • Abstract
      • Slides

      Background:
      Intrathoracic neurogenic tumors are uncommon and typically originate from the peripheral nerves, paraganglionic nerves, or the autonomic nervous system. They are commonly found in the mediastinum, especially in the posterior mediastinum and have a variety of clinical and histological features. Mediastinal neurogenic tumors in adults are generally benign lesions.

      Methods:
      We retrospectively reviewed our institutional experience of mediastinal neurogenic tumors from 2010 to 2015. The patients were evaluated according to age, gender and histological characteristics of the tumor.

      Results:
      There were 78% males and 22% females diagnosed with mediastinal neurogenic tumors. Mean age was 48.4±12 years. Distribution according to the histopathological diagnosis was: 56% schwannoma, 22% malignant schwannoma, 22% ganglioneuroma. The operative procedure performed in all cases was tumor extirpation through thoracotomy. In 10% of cases, presence of intraspinal growth was encountered (the so-called "dumbbell tumors"), thus hemilaminectomy was performed. There were no operative deaths and minimal morbidity. Mean postoperative stay was 5 days.

      Conclusion:
      In this study, the most common mediastinal neurogenic tumor found was schwannoma. Neurogenic tumors arising in the mediastinum are generally of benign nature and mostly found in males. The treatment of choice for malignant and benign mediastinal neurogenic tumors is complete resection for the purposes of avoiding local invasion, facilitating differential histopathological diagnosis and preventing malignant degeneration. The surgical management of the dumbbell tumors differs from others.

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      P2.04-045 - Management of Malignant Pleural Effusions: Ten Years Experience of a Single Center (ID 4631)

      14:30 - 15:45  |  Author(s): F. Caushi

      • Abstract
      • Slides

      Background:
      Malignant pleural effusions (MPE) are a common clinical problem for patients with neoplastic disease. MPE may be an accompanying sign of them and sometimes the first sign. This study is an overview of diagnosis and treatment of MPE and its aim is to assess the role of invasive procedures in management of such patients.

      Methods:
      This is a retrospective study for a period of ten years where have been examined all clinical cartels of patients with pleural effusions. All date are analyzed with Pearson Chi-Square test.

      Results:
      This study has demonstrated that MPE represent 10 % of all pleural effusions. 46% of them have been smokers. 53% of MPE was in the right hemithorax, 38% in the left hemithorax and only 9% was bilateral. The age range was (18-91), and the average age was 63 years old. 37% of these patients have had recent surgery for neoplasia, and in 27% there is no information for recent malignancy and pleural fluid was the first sign of patients. 14% of these patients have relatives with neoplasia. 48% of the cases underwent to biopsy via Video Assisted Thoracic Surgery (VATS) meanwhile for the others the diagnosis was decided by fibrobronchoscopy. In 90% of cases the definitive surgical treatment was pleural drainage and chemical pleurodesis(sol betadine 20 ml + sol NaCl 0,9% 80 ml), in 5% of cases the patient underwent to partial pleurectomy and in 5% of cases wasn’t performed any surgical procedure. Hospitalization day average was 9 days. Performance status was: in 60.2% of cases improved, in 37.2% of cases the same and 2.3% of cases died in hospital. Positive result of pleural biopsy was in 97% of cases. The main hystotype was Adenocarcinoma of lung in men (35% of cases) and Ductal carcinoma of breast (18% of cases) followed by Adenocarcinoma of lung (10% of cases) in women. Mesotelioma was found in 7% of cases.

      Conclusion:
      Pleural fluid analysis and cytology should continue to be a first-line investigation to screen out the suspiciously MPE cases, as it is a very convenient, cost-effective and safe investigation. Its combination with pleural biopsy through VATS represents the key of success in diagnosing pleural malignant lesions. The most appropriate surgical treatment for MPE seems to be pleural drainage and chemical pleurodesis because of their origin mostly extrapleural malignancy.

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