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D. Kızılgöz



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    P1.05 - Poster Session with Presenters Present (ID 457)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
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      P1.05-078 - The Relationship between IASLC/ATS/ERS Grading System of Adenocarcinoma of the Lung and Quantitive PET Parameters (ID 5338)

      14:30 - 15:45  |  Author(s): D. Kızılgöz

      • Abstract

      Background:
      There are differences in terms of survival even in early stage adenocarcinomas and subtypes of tumor are the most particular factor. The aim of the study was to investigate the relationship between International Association for the Study of Lung Cancer (IASLC)/ American Thoracic Society (ATS)/ European Respiratory Society (ERS) grading system of the adenocarcinoma and quantitative PET parameters in terms of survival.

      Methods:
      179 operated adenocarcinoma patients categorized according to grade, histological subtypes (Table 1). All patients underwent complete resection and lymph node resection. Invasive adenocarcinoma (MIA) and adenocarcinoma in situ (AIS) were excluded. PET/CT images were re-evaluated and MTV, TLG and SUV-max of primary tumors were calculated. Correlations between quantitative PET parameters and both tumor and overall survival were analysed.

      Results:
      A strong correlation was detected in terms of tumor size between pathologic tumor size and PET-BT (p<0.001, r=0.816). If the SUV-max of tumor/ lymphadenopathy (LAP) ratio cut-off is taken as <2.5, it is significantly higher to detect metastatic lymph node (p<0.001). SUVmax value had weak negative correlation with survival (p=0.004 r= - 0,220). 49.6 was determined as cut-off value for TLG and 9.68 cm3 was for MTV. 1, 2, 3 and 5 years survival rates were indicated in Table 1 There were significant relation between survival and SUVmax, tumor size (PET-BT and CTT) and TLG (p<0,05). In this study over-all survival rates for 1, 2, 3 and 5 years were 88.9%, 77.8%, 76.4% and 66.1%.

      Survival rates 1 year 2 years 3 years 5 years p value
      TLG<49.6 88.9 70.4 69 51.6 p=0.0051
      TLG>49.6 91.5 87.3 85.9 82.2
      MTV<9.68 89.5 72.1 70.8 53.3 p=0.002
      MTV>9.68 89.6 85.1 83.6 79.9


      Conclusion:
      Although, there was no correlation between tumor grade and PET parameters, PET/CT is an important imaging modality for a more accurate T staging and prediction of lymphatic metastasis and survival. To our opinion quantitative PET parameters can help to decide on treatment options and it is possible to avoid unnecessary treatment and to decrease treatment related morbidity rate.

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    P1.06 - Poster Session with Presenters Present (ID 458)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P1.06-038 - Survival and Prognostic Factors of Oligometastatic Non-Small Cell Lung Carcinoma: A Single Center Experience (ID 5283)

      14:30 - 15:45  |  Author(s): D. Kızılgöz

      • Abstract

      Background:
      In patients without targeted mutations platinum-based chemotherapy is still current treatment method with a median survival rates of 8-11 months. Patients with single side oligo-metastatic disease should be consider for curative aggressive therapies for both primary and metastatic sides for better survival (NCCN 2016).

      Methods:
      Totally 19 oligo-metastatic NSCLC patients was evaluated retrospectively by using hospital database. All patients had single metastatic side.

      Results:
      Among 19 eligible patents there was male predominance (n= 16, 84.2%). Eight patients had co-morbidities requiring regular medication. Histopathological, there were 13 (68.4%) adenocarcinoma and 6 (31.6%) non-adenocarcinoma. While brain was the most common site for metastasis 10 (52.6%), it was followed by bone (n=6, 31.6%). Treatments for primary tumour side were surgery (n=6, 31.7%), concurrent CRT (n=5, 26.3%) and sequential CRT (n=1, 5.3%). Median follow-up for whole cases were 59.1 weeks. Median overall survival (OS) and progression free survival (PFS) were 140 (±33.7) and 76 (±24.2) weeks respectively. Progressions were observed mostly in 45.4. week. Univariate cox regression analyses for OS and PFS is indicated in Table 1. Clinical T and N staging had significant relation with OS (p=0.02 and 0.03 respectively). There was no relation between bone or brain metastasis and histopathology, gender, clinical T and N staging. Median survival after first progression (SAFP) was 63 weeks (±SS 29.05). Among study parameters only clinical T staging had significant relation with SAFP (p=0.026). Median SFAP was better in patients with progression of primary tumour however median OS was better in patients with progression of distant metastasis (p>0.05).

      Factor OS PFS
      Hazard Ratio p Hazard Ratio p
      Age (cut-off=65) 1.034 (0.18-5.1) 0.96 0.4 (0.1-2.2) 0.3
      Co-morbidity 2.3 (0.54-9.8) 0.24 3.4 (0.8-14) 0.07
      Brain Metastasis 0.88 (0.21-3.6) 0.86 1.5 (0.42-5.45) 0.52
      Histopathology (adeno vs non-adeno) 0.22 (0.03-1.4) 0.10 0.67 (0.16-2.8) 0.6
      Bone Metastasis 1.78 (0.43-7.31) 0.42 1.7 (0.47-6.6) 0.4
      pN Staging (n0 and N1-2) 0.12 (0-173) 0.21 0.94 (0.22-4.02) 0.94
      cT Staging 2.17 (1-4.7) 0.02 1.11 (0.73-1.81) 0.54
      cN Staging (n0 and N1-2) 2.3 (0.86-6.6) 0.03 1.77 (0.79-3.97) 0.1
      Non-surgical curative treatment 1.88 (0.41-8.52) 0.42 1.9 (0.50-7.38) 0.34
      Surgery 0.31 (0.06-1.65) 0.14 0.21 (0.02-1.78) 0.09


      Conclusion:
      Even oligo-metastatic NSCLC means stage 4 of disease, curative treatment approaches for both primary and metastasis sides can increase patients’ prognosis than other stage 4 cases. Similar to the existed retrospective studies we had OS more than 2 years and PFS more than 1 year.