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Cengiz Gebitekin



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    P1.14 - Thymoma/Other Thoracic Malignancies (Not CME Accredited Session) (ID 946)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.14-09 - Outcome After Lung Resection for Primary Lung Carcinomas/Metastasis in Patients with Performed Total Laryngectomy for Laryngeal Carcinoma (ID 14159)

      16:45 - 18:00  |  Author(s): Cengiz Gebitekin

      • Abstract

      Background

      Total laryngectomy remains the treatment of choice for recurrent / persistent laryngeal carcinoma after radiotherapy or chemoradiotherapy. These patients with laryngeal carcinoma are at risk for developing both pulmonary metastasis and second primary lung cancer. Because of the persistent tracheostomy, postoperative management after lung resection is usually a difficult process. Ineffective evaluation of preoperative pulmonary functions, failure of single lung ventilation due to short trachea, inadequate respiratory physiotherapy are frequently encountered problems. The purpose of this study is to evaluate the outcomes of lung resection in patients with persistent tracheostomy due to laryngeal carcinoma.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between Jan 2006- Jan 2016, the data of 9247 patients who underwent lung resection at three different centers were retrospectively examined. The study group consisted of 68 patients (62 male, mean age 59.49 ± 11.4 (31-82)) who had persistent tracheostomy due to laryngeal carcinoma. Patient preoperative evaluation parameters, operation techniques, postoperative complications and survival were analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      The mean time between the two operations was 55.68 ± 64.8 (3-312) months. Pulmonary tumors were located in the upper lobe in 53 patients (77.9%), in the lower lobe in 11 patients (16.1%), in the middle lobe in 2 patients (3%) and bilaterally in 2 patients (3%). Lung resection was performed with thoracotomy in 53 patients (78%) and videothoracoscopy in 15 patients (22%). Extent of lung resection was sublobar resection in 28 patients (41.2%), lobectomy in 37 patients (54.4%) and pneumonectomy in 3 patients (4.4%). Histopathological examination revealed squamous cell carcinoma in 53 (78%) patients and other non-small cell lung carcinomas in 15 (22%) patients. Postoperative complications were present in 24 patients (35.3%). The most common complications observed were prolonged air leak in 7 patients (10,3%), space in 6 patients (8.8%) and pneumonia in 5 patients (7.3%). Mortality was seen due to respiratory insufficiency in 2 (2.9%) patients who underwent right lower bilobectomy and right pneumonectomy. The 5-year survival rate after lung resection was 31.6% and the median follow-up time was 32 months ± 8.45.

      8eea62084ca7e541d918e823422bd82e Conclusion

      This study shows that the presence of a tracheostomy should not be considered a risk factor for pulmonary resection if there is close cooperation between pulmonary medicine, anesthesia and thoracic surgery clinics. In these patients, besides other lung resections, videothoracoscopic lung resections can be performed safely and good oncologic results can be obtained.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.16-33 - Adenosquamous Carcinoma of the Lung: Comparison of Surgical Outcomes with Squamous Cell and Adenocarcinoma (ID 14235)

      16:45 - 18:00  |  Author(s): Cengiz Gebitekin

      • Abstract

      Background

      Lung adenosquamous carcinoma (ASC) is a rare subtype of lung cancer that contains squamous cell carcinoma (SCC) and adenocarcinoma (AC) components. Clinical and prognostic features have not been fully established. The aim of the study is to compare the clinical characteristics and survival outcomes of ASC, AC and SCC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      In our clinic, the data of 1076 patients who underwent segmentectomy, lobectomy, or pneumonectomy due to non-small cell lung cancer between 1996-2016 was recorded prospectively and reviewed retrospectively. Patients with histologically proven tumor cell type ASC (n = 25, 2,32%), AC (n = 350, 32,52%) and SCC (n = 740, 50,18%) were included in the study. Univariate and multivariate analysis were performed to determine prognostic factors. The Kaplan-Meier method was used for survival analysis.

      4c3880bb027f159e801041b1021e88e8 Result

      Our study group consisted of 915 patients (834 (91.15%) male, mean age 60.87 ± 9.02 (30-87) years). 65 (7,1%) patient underwent segmentectomy, 711 (77,7%) lobectomy and 139 (15,2%) pneumonectomies were performed as lung resections. Morbidity was seen in 326 patients (35.6%). Postoperative 90-day mortality rate was 2.95% (n = 27). When the demographic data was analyzed between the three groups, female gender was 18% in AC and 4% and 3.1% in ASC and SCC, respectively (p <0.001). In the preoperative positron emission tomography, the maximum standard uptake median value was 13,47 in SCC and 11,73 and 9,40 in ASC and AC, respectively (p <0.001). Pneumonectomy rate was 20.74% in SCC and 16% and 6.57% in ASC and AC, respectively (p <0.001). Early stage (stage 1) patients were 41.4% in the AC group and 28% and 35.7% in ASC and SCC respectively. While the presence of lymphatic metastasis was 36% in the ASK group; the rates were 31.7% and 29.6% in AC and SCC, respectively (p = 0.675). There was no statistically significant difference between the groups in terms of survival (p = 0.659, graph 1) after weighted Log-Rank test using Propensity score weights calculated for each cell type in case of more than two groups.

      8eea62084ca7e541d918e823422bd82e Conclusion

      ASCs are rare, malignant tumors that includes features of SCC and AC cell types, and frequently involves lymphatic metastases. However, there was no difference in survival when compared with AC and SCC.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P2.17 - Treatment of Locoregional Disease - NSCLC (Not CME Accredited Session) (ID 966)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.17-24 - Does the Change in Body Mass Index During Induction Chemo/Chemoradiotherapy Affect the Outcome of Surgery in Locally Advanced NSCLC? (ID 14199)

      16:45 - 18:00  |  Author(s): Cengiz Gebitekin

      • Abstract

      Background

      In the literature, the affect on prognosis due to changes in Body Mass Index (BMI) for patients diagnosed with cancer have been extensively analyzed. However, there are no studies investigating changes in BMI during induction therapy and its affect on postoperative outcomes. In this study, we aimed to identify how changes in BMI during induction therapy affected morbidity, mortality and long-term survival rates in patients undergoing surgery for locally advanced NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      One hundred and seventy one patients with locally advanced NSCLC and undergoing lung resection after induction therapy between 2011 and 2016 were prospectively recorded into the database and retrospectively evaluated. Induction treatment consisted of chemotherapy in 131 (76.6%) and chemoradiation in 40 (23.4%) patients. Body mass index was calculated at the initaition of induction therapy and before surgery. Pathological complete response to induction treatment, morbidity, 90-days mortality, long-term survival and prognostic factors were compared in the light of BMI.

      4c3880bb027f159e801041b1021e88e8 Result

      All but 15 patients were male with a mean age of 59.4 (range 26-76y) years. The median BMI before induction treatment was 25.1 (16-39) and 25.2 (17-38) before surgery. The BMI decreased in 26.3% and remained steady/or increased in 73.7% of the patients during induction treatment. The complete response rate was 27(15.8%) patients [4 (11.8%) in the decreased BMI group and 23 (16.8%) in the BMI steady/increased group, p=0.47]. Morbidity rate was 42.6% ( 43.8% in decreased BMI and 38% in the BMI steady/increased group, p=0.5). Mortality rate was 4% (5.8% in decreased BMI and 3.6% in BMI steady/increased group, p=0.7). Three years survival rate was 71% (55.6% in the decreased BMI group and 76% in BMI steady/increased group, p=0.029)

      8eea62084ca7e541d918e823422bd82e Conclusion

      In this study we observed that nutrutional status of the patients undergoing induction therapy and surgery needs clear attention because morbidity, mortality and long term survival rates were negatively impacted in patients with a decline in their BMI during induction treatment.

      6f8b794f3246b0c1e1780bb4d4d5dc53