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T. Mehmood



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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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      65P - Lymph node metastases in clinically node negative peripheral non-small cell lung cancer (ID 207)

      12:30 - 13:00  |  Author(s): T. Mehmood

      • Abstract

      Background:
      Small lung cancers are increasingly detected with the advent of low dose spiral computed tomography and lung cancer screening programme, and these lesions are frequently subsolid and low risky pN+ disease. Integrated positron emission tomography/computed tomography (PET/CT) is widely used in lymph node staging with higher accuracy and sublobar resection may be appropriate in cN0 NSCLC. This retrospective study was designed to identify the risk factors and pattern of lymph node metastases in NSCLC.

      Methods:
      107 consecutive cN0 patients with 1 cm to 2 cm peripheral NSCLC who underwent PET-CT scans followed by curative-intent resections in our hospital were enrolled in this study. Clinical and pathological data were analyzed by multivariate analysis retrospectively, including tumor size, tumor SUVmax, ratio SUVmax tumor/SUVmax liver. Lymph nodes of metastases were analyzed in pN+ patients.

      Results:
      8.5% (9/107) PET-CT diagnosed N0 NSCLC cases had pathological lymph node metastases, including 8 N1 and 3 N2 involvement (1 skipping N2 metastases). Univariable and multivariable analysis of clinicopathological factors (including tumor size, ratio SUVmax tumor/liver) found no independent risk factor for lymph node metastases. All N(+) cases were adenocarcinoma while 66.7% (6/9) of the N(+) cases were single station metastases. The lymph node metastasis rate of solid NSCLC and GGO were 10.7% and 0% (P=0.224), respectively.

      Conclusions:
      The lymph node rate of 1 cm to 2 cm NSCLC is relatively high and intrapulmonary lymph nodes were higher risk than mediastinal lymph nodes. However, no predictors of lymph node metastases were detected in this population. Sublobar resection can be an alternative procedure for GGO lesions as no lymph node metastases were found, but for solid NSCLC, thorough lymph node sampling should be performed to rule out lymph node metastases before making the decision of segmentectomy.

      Clinical trial identification:


      Legal entity responsible for the study:
      SKMH, Lahore

      Funding:
      SKMH, Lahore

      Disclosure:
      The author has declared no conflicts of interest.

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      79P - Long term survival of stage IIIB non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation (ID 208)

      12:30 - 13:00  |  Author(s): T. Mehmood

      • Abstract

      Background:
      The optimal treatment strategy for Stage IIIB NSCLC patients with a T4N0-1 tumor is a matter of debate. In prospective combined modality series including surgery, the median overall survival (OS) is approximately 24 months. We hypothesized that results comparable to regimens including surgery can be achieved with concurrent chemoradiation in this patient group.

      Methods:
      In our retrospectively collected database of NSCLC patients, all patients with T4 (mediastinal invasion) N0-1 NSCLC receiving concurrent chemoradiation were included. One patient had a recurrence after previous pneumonectomy. All patients were given 3 cycles of chemotherapy (cisplatin and etoposide). Radiotherapy (RT) was started at the 2nd course of chemotherapy. OS was calculated from date of diagnosis (Kaplan-Meier method). Toxicity was scored according to CTCAEv3.0.

      Results:
      42 patients (8 females, 34 males) with a median age of 62.5 ± 9 years (44-80 years) were included from January 2005 until December 2009. Stage distribution: 86% T4N0 (n = 36), 14% T4N1 (n = 6). The maximal tumor dose was 66 Gy using conventional fractionation. The median prescribed mean lung dose was 15 ± 4.4 Gy (5.03 -19.9 Gy). Acute toxicity: 1 patient experienced grade 3 dyspnea during RT. Grade 3 dysphagia occurred in 5 patients (12%) during RT requiring tube feeding in 3 of these patients (7%). Dysphagia persisted later than 1 month after RT in 1 patient (2%). Grade 3 dysphagia only occurred in patients treated concurrently. Grade 3 cough occurred in 1 patient during RT, no patient experienced grade 3 cough 1 month after RT. 2 patients died within 3 months after start of RT, one due to myocardial infarction, one of unknown causes. Severe late toxicity was not present: no grade 3 complications more than 3 months after the end of radiotherapy. With a median follow-up of 42 months, the median OS for the whole group is 34 months (95% CI 24-43 months). 2-year OS survival is 55%.

      Conclusions:
      Concurrent accelerated chemoradiation using an individualized dose prescription is a valid treatment strategy for stage IIIb, T4N0-1 NSCLC patients yielding very promising OS results with low toxicity.

      Clinical trial identification:


      Legal entity responsible for the study:
      SKMH, Lahore

      Funding:
      SKMH, Lahore

      Disclosure:
      The author has declared no conflicts of interest.