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Dimitra Grapsa
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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 2
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.01-69 - Safety and Efficacy of Percutaneous Computed Tomography-Guided Thermal Ablation of Non-Small Cell Lung Cancer Metastases (Now Available) (ID 1147)
08:00 - 18:00 | Author(s): Dimitra Grapsa
- Abstract
Background
Percutaneous computed tomography-guided (CT-guided) thermal ablation is a minimally invasive method for the treatment of adrenal metastases, painful bone metastases and liver metastases originating from non-small cell lung cancer (NSCLC). We aimed to further evaluate the safety and efficacy of CT-guided radiofrequency ablation (RFA) and microwave ablation (MWA) in the management of metastases in a real-life cohort of NSCLC patients.
Method
The medical records of 142 patients with metastatic NSCLC (71, 32 and 40 patients with adrenal metastases, painful bone metastases and liver metastases, respectively) treated with CT-guided RFA or MWA were retrospectively studied. The efficacy of thermal ablation was evaluated by post-ablation imaging. For painful bone metastases, palliation was assessed by the Brief Pain Inventory (BPI) score.
Result
Technical success of CT-guided thermal ablation was 100%. No major complications occurred. Among patients with adrenal metastases treated with RFA or MWA, local recurrence was observed in 17.1% and 19.4% of cases at 1-year follow up, respectively. In patients with painful bone metastases, significant pain relief was noted after thermal ablation (p<0,001). Local recurrence was observed in 3.3% of cases with liver metastases at 1-year follow-up.
Conclusion
CT-guided RF and MW ablation is a safe and effective local treatment for the management of adrenal, bone and liver metastases from NSCLC. For painful bone metastases RF ablation provides significant pain relief.
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EP1.01-90 - The Prognostic Role of Mean Platelet Volume in Patients with Advanced Non-Small Cell Lung Cancer (Now Available) (ID 1039)
08:00 - 18:00 | Author(s): Dimitra Grapsa
- Abstract
Background
Previous studies suggest the potential correlation between increased mean platelet volume (MPV) and survival in non-small cell lung cancer (NSCLC), but results are often contradictory. We herein aimed to further evaluate the prognostic value of MPV in patients with advanced-stage NSCLC in the real-world setting of a tertiary referral oncology center.
Method
Demographic, clinicopathological and laboratory data (including complete blood count parameters) of 30 patients with stage IIIB or IV NSCLC were retrieved from the Lung Cancer registry of the Oncology Clinic of Sotiria Athens General Hospital and analyzed. All the above variables (including MPV) were correlated to each other, as well as with overall survival (OS) and progression-free survival (PFS).
Result
Mean patients’ age was 68,5 (SD=7,5) years. The majority of patients were male (76.7%), had positive smoking history (90%), squamous cell carcinoma (53.3%), and stage IV disease (76.7%). No statistically significant correlations between survival and sex, age, smoking history or tumor histology (squamous cell carcinoma versus adenocarcinoma), or between MPV and histology were noted. Worse performance status (p=0.004) and higher white blood cell count (p=0.01) were correlated with reduced OS, while increased MPV was strongly correlated both with OS and PFS (p<0.0001 in both cases).
Conclusion
Increased MPV may correlate with improved survival of patients with NSCLC, thus potentially representing a marker of favorable prognosis. Our study findings warrant confirmation in larger prospective series
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EP1.11 - Screening and Early Detection (ID 201)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.11-03 - Diagnostic Evaluation of Patients with Solitary Pulmonary Nodules in a Tertiary Referral Center (Now Available) (ID 1145)
08:00 - 18:00 | Author(s): Dimitra Grapsa
- Abstract
Background
Management of patients with Solitary Pulmonary Nodules (SPN) is primarily targeted at achieving an early diagnosis and treatment of all malignant nodules. We herein aimed to assess the adherence of pulmonologists to current clinical practice guidelines for SPN evaluation in a tertiary referral center for thoracic diseases.
Method
The medical records of 64 patients with SPN, diagnosed and treated at Sotiria Hospital for Chest Diseases from January 2017 to September 2018 were retrospectively reviewed. Following analysis of the clinical features and imaging characteristics of all cases, the probability of malignancy was evaluated, and the management approach followed by pulmonologists was compared to the approach suggested by issued guidelines.
Result
We observed a tendency by pulmonologists to monitor all SPN irrespective of size, density and likelihood of malignancy and reassess them at an earlier time than recommended by guidelines. Use of PET/CT in solid nodules > 8 mm of very low (50%) and high (80%) probability of malignancy was also observed, despite lack of a clear indication of PET/CT in the above patients’ groups. Conventional bronchoscopy was performed in 81% of patients with a SPN of > 8 mm with intermediate and high probability of malignancy, even though this is not typically recommended. A low-dose protocol was applied in the majority of SPN cases monitored by computed tomography, in accordance with guidelines. Malignancy was diagnosed in 42/64 patients.
Conclusion
Pulmonologists in real-world practice may adopt a more "aggressive" management approach towards patients with SPN, so as to exclude the possibility of an underlying malignancy.
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EP1.13 - Staging (ID 203)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Staging
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.13-02 - Negative Predictive Value of EBUS-TBNA for Mediastinal Staging of Non-Small Cell Lung Cancer (Now Available) (ID 1037)
08:00 - 18:00 | Author(s): Dimitra Grapsa
- Abstract
Background
Mediastinal staging must precede surgery in patients with resectable non-small cell lung cancer (NSCLC). According to current guidelines, minimally invasive techniques, such as endobronchial ultrasound with transbronchial needle aspiration or/and biopsy (EBUS–TBNA/B), represent the preferred first-line approach for mediastinal staging, before performing mediastinoscopy. We herein aimed to evaluate the negative predictive value (NPV) of EBUS-TBNA in a tertiary referral center and correlate NPV with primary tumor features and other clinicopathological variables.
Method
We retrospectively studied the medical records of 20 patients with resectable NSCLC, submitted, from January 2017 to January 2018, to EBUS-TBNA in the Department of Interventional Pulmonology of the first Pulmonology Clinic of Sotiria Athens General Hospital; EBUS-TBNA had been performed prior to surgical resection of the primary tumor and surgical lymph node staging in all patients. The EBUS-TBNA results were correlated with surgical staging.
Result
Among all lumph node stations sampled, there were 46 with negative EBUS-TBNA results. Post-operatively, 6 EBUS-TBNA negative lymph nodes were re-staged as positive. The remaining 40 EBUS-TBNA negative nodes were true negative, as confirmed by surgical staging. NPV of EBUS-TBNA was 87%, and thus within the range of previously published results. Among cases with negative ΕΒUS-TBNA results, a statistically significant correlation was observed between low NPV (false negative EBUS-TBNA) and T3 tumor size (> 7cm), pre-bronchoscopy N2 disease, presence of necrosis within the primary tumor, and microscopic vascular invasion (p-value <0.05 in all cases).
Conclusion
Patients with Τ3 tumors (>7cm), Ν2 disease before the performance of EBUS-TBNA, and those with tumor necrosis or microscopic vascular invasion may be at greater risk for false negative EBUS-TBNA results. Given the small sample size of our study and its retrospective study design, it must be emphasized that these findings are highly preliminary and must be confirmed in larger prospective series.
