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Charalambos Zisis



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    EP1.12 - Small Cell Lung Cancer/NET (ID 202)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.12-14 - Multiple Primary Malignant Neoplasms in Patients with Small Cell Lung Cancer. The Experience of Our Center (Now Available) (ID 715)

      08:00 - 18:00  |  Author(s): Charalambos Zisis

      • Abstract
      • Slides

      Background

      Treatment and, mainly, modern diagnostic tools during the first diagnosis of the disease and follow-up, seem to improve survival in patients with small cell lung cancer (SCLC) and thus increase the number of patients diagnosed with multiple primary malignant neoplasms.

      Method

      The aim of this retrospective study was to estimate and report the incidence of multiple primary malignant neoplasms and discuss the clinical characteristics of this subgroup of patients with SCLC.

      The study includes all patients consecutively admitted between 1/1983 -3/2019 at the Department of Medical Oncology, Evangelismos General Hospital, Athens, Hellas.

      Result

      Five hundred fifty eight patients [386(69%) men, 172(31%) women, 285(51%) with limited and 273(49%) with extended disease] were included in the study. Median age was 63 (33-87)years, median ECOG was 2 (0-4) and median time of follow-up was 18+ (1+ - 696+) months. Three hundred ninety six (71%) had a short period of follow-up ≤24 months (group A), while 162 had a period of follow-up >24 months (group B). Multiple primary malignant neoplasms were detected in 23(4%) patients, 20(5%) men and 3 (2%) women (p<0.05), synchronous in 11(48%) and metachronous in 12(52%) patients, p=NS. The second malignant neoplasms were lung adenocarcinoma, squamous cell lung carcinoma, colon adenocarcinoma, bladder transitional cell carcinoma, head and neck squamous cell carcinoma, prostate adenocarcinoma, NHL, and thyroid follicular carcinoma in 7, 5, 4, 3, 2, 1 and 1 cases respectively. In the group of the 285 patients with limited disease 16(6%) multiple primary malignant neoplasms were observed in relation to 7/273(2.5%) of the patients with extensive disease (0.01< p<0.05). The multiple primary neoplasms were 12/396(3%) and 11/162(7%), p <0.05 in patients of the groups A and B respectively.

      Conclusion

      1. Development of multiple primary malignant carcinomas in patients with SCLC, does not seem to be a rare phenomenon. 2. The great majority of the multiple primary carcinomas (lung adenocarcinomas, squamous cell lung carcinomas, bladder transitional cell carcinomas, head / neck carcinomas) is smoking dependent. 3. The risk was higher in males, in patients with limited disease and in those surviving more than 24 months.

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    MA20 - Thymic Tumors: From Molecular to Clinical Results and New Challenges in Other Rare Thoracic Tumors (ID 149)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Thymoma/Other Thoracic Malignancies
    • Presentations: 1
    • Now Available
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      MA20.07 - Thymomectomy and Total Thymectomy or Simple Thymomectomy for Early Stage Thymoma Without Myasthenia Gravis: An ESTS Thymic Working Group Study (Now Available) (ID 1683)

      11:30 - 13:00  |  Author(s): Charalambos Zisis

      • Abstract
      • Presentation
      • Slides

      Background

      Resection of thymic tumors has traditionally included removal of the tumor and the thymus gland (thymothymomectomy). Nevertheless, in recent years, some authors questioned the need to remove the thymus gland in non-MG thymomas, suggesting that resection of the tumor (simple-thymomectomy) is enough from an oncological point of view in Stage I (TNM stage classification) thymoma patients. The aim of our study was to compare short- and long-term outcome of thymothymomectomy vs. simple-thymomectomy using European Society of Thoracic Surgeons (ESTS) Thymic Database.

      Method

      We investigated 1131 patients with thymic epithelial tumors included in the ESTS-Thymic Database. Three-hundred twenty-four clinical stage I (cT1N0M0, according to the 8th edition of the UICC/AJCC TNM stage classification) without Myasthenia Gravis (non-MG) thymoma cases were evaluated from 23 contributing centers (2000-2017), of which 300 (93%) thymothymomectomy and 24 (7%) simple-thymomectomy. Surgical upstaging was evaluated. In pathological stage I, we compared the completeness of resection, the rate of complications, the 30-day mortality, the overall survival and the disease-free survival (DFS).

      Result

      Overall, we observed an upstaging to stage III in 10 (3%) patients. We did not observe any significant difference between the two techniques in terms of the completeness of resection, the rate of complications and the 30-day mortality. The 5-year overall survival rate was 94% in the thymothymomectomy group and 56% in the simple-thymomectomy group (Figure 1 - P= 0.0004). The 5-year DFS was 95% in the thymothymomectomy group and 82% in the simple-thymomectomy group (Figure 1 -P= 0.013).

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      Conclusion

      Patients affected by stage I TNM non-MG thymoma submitted to thymothymomectomy presented a significantly better DFS and overall survival than those submitted to simple-thymomectomy. Thymothymomectomy should be considered the procedure of choice in Stage I TNM non-MG thymomas, also considering the not negligible rate of pathological upstaging.

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