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A. Silva



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    Poster Display Session (ID 63)

    • Event: ELCC 2017
    • Type: Poster Display Session
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
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      169P - Pulmonary carcinoid tumors: Experience from an oncology center (ID 454)

      12:30 - 13:00  |  Author(s): A. Silva

      • Abstract

      Background:
      Pulmonary carcinoid (PC) tumors are a rare group of pulmonary neoplasms, characterized by neuroendocrine differentiation and indolent clinical behavior. Typical carcinoid (TC) account for the majority of cases, are low-grade and rarely metastasizes. Atypical carcinoid (AC) have worse prognosis, with greater tendency to metastasize and recur locally.

      Methods:
      Retrospective analysis of histologically confirmed PCs diagnosed between 2008 and 2016. Descriptive analysis of the main demographic, clinical and prognostic characteristics was performed. Overall survival (OS) was evaluated using the Kaplan-Meier.

      Results:
      We identified 55 patients (PTS). TC 58.2% (n = 32), AC 36.4% (n = 20), not other specified 3.6% (n = 2) and one case of combined TC and AC (bilateral). Female 56.4% (n = 31), male 43.6% (n = 24). Median age 62 years (range 18-83). Current smoker (SMK) 10.9% (n = 6), ex-SMK 10.9% (n = 6) and non-SMK 58.2% (n = 32). Secondary malignancies in 27.3% (n = 15) of PTS: thyroid (n = 4), breast (n = 3), prostate (n = 3), colorectal (n = 2), endometrium (n = 1), cervix (n = 1) and non-small lung cancer (n = 1). Staging (AJCC 7th Ed.): I (65.5%, n = 36), II (7.3%, n = 4), III (7.3%, n = 4), IV (16.4%, n = 9). Surgery was performed in 38 (86.3%) PTS with localized disease: lobectomy 78,9% (n = 30) pneumonectomy 13.2% (n = 5) and segmentectomy 7.9% (n = 3) and the majority (>90%) had systematic nodal dissection. One PT had adjuvant chemotherapy (CT) - stage IIIA. Recurrence was documented in 5 PTS submitted to complete resection. For advanced or recurrent disease, first line systemic treatment (Tx) was proposed in 9 PTS: somatostatin analogues (SA) (n = 3), CT (n = 3) and SA + CT (n = 3). The CT regimens were platinum + etoposide, streptozocin (STZ) + 5-FU and STZ + doxorubicin. Two PTS were treated after disease progression with further CT, one of them received 177Lutetium DOTA octreotide. 4 PTS underwent radiotherapy in palliative setting. Radioembolization was used to treat liver metastasis in 3 PTS. 5-year OS was 76,2%.

      Conclusions:
      PC’s diagnosis and Tx require an experienced multidisciplinary team. Our results corroborate the literature data regarding epidemiology, high percentage of localized disease amenable for surgery and OS. Despite the emergence of new therapies, advanced disease remains with limited Tx options.

      Clinical trial identification:


      Legal entity responsible for the study:
      Instituto Português de Oncologia do Porto

      Funding:
      Instituto Português de Oncologia do Porto

      Disclosure:
      All authors have declared no conflicts of interest.

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      57P - small cell lung cancer: Retrospective review of an institution (ID 508)

      12:30 - 13:00  |  Author(s): A. Silva

      • Abstract

      Background:
      Small cell lung cancer (SCLC) account for 10 to 15% of lung cancers. Despite the high rate of response to chemotherapy and radiotherapy, it is characterized by a rapid growth and development of widespread metastases.

      Methods:
      Retrospective review of patients with SCLC with diagnosis between January 2013 and December 2016 in our institution - Portuguese Oncology Center, Porto. Descriptive analysis and survival evaluation by Kaplan-Meier method. Evaluation of differences between survival curves by log rank test.

      Results:
      From the 144 patients included, 115 (79.9%) were male and the mean age was 65 years (range 42-87). The majority of patients had an ECOG PS 0-1 at diagnosis (n = 91, 64.1%). History of smoking was present in 115 patients (79.8%). Ki-67 was analyzed in 38 patients (36.4%) and was ≥50% in 30 patients. 108 patients (75%) had metastatic disease at diagnosis, more frequently bone (n = 61, 42.4%) and liver (n = 50, 34.7%) metastasis. Initial treatment had palliative intent in 118 patients (81.9%), and 41 (28.5%) underwent only symptomatic treatment. The most commonly used chemotherapy regimen was the doublet of platinum and etoposide (n = 98, 95.1%). The overall response rate (ORR) was 64%. Median overall survival (OS) was 5.5 months (95% confidence interval (CI) 2.9-7.9). Within patients submitted to radical treatment (n = 26, 18.1%), there was relapse in 15 (57.7%), with a median disease free survival of 10.5 months (95% CI: 9.4-11.7). Within patients submitted to palliative treatment there was progression in 43 (not evaluated in 28), with a median progression free survival of 6.3 months (95% CI: 5.9-6.7). The median OS of the patients without metastatic disease at diagnosis was significantly higher than those with metastatic disease (median 15.9 months, 95% CI: 12.3-19.4 versus 3.1 months (95% CI: 2.1 -4.1, p < 0.001).

      Conclusions:
      The results obtained in our sample are in agreement with the existing literature. The discovery of predictive and predictive biomarkers as well as new forms of treatment is urgently needed.

      Clinical trial identification:


      Legal entity responsible for the study:
      Instituto Portugues de Oncologia do Porto (Portuguese Oncology Institute of Porto, Portugal)

      Funding:
      Instituto Portugues de Oncologia do Porto (Portuguese Oncology Institute of Porto, Portugal)

      Disclosure:
      All authors have declared no conflicts of interest.