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Katia Roque Perez



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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
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.12-30 - Clinicopathological Features and Survival of Lung Neuroendocrine Tumors (ID 2865)

      08:00 - 18:00  |  Author(s): Katia Roque Perez

      • Abstract

      Background

      Lung neuroendocrine tumors (NETs) are a heterogenous group of malignances classified into four histological types, being small cell lung cancer (SCLC) the most frequent and mortal. Due to the rarity of the disease, limited clinical data is available for NTEs. Herein we aim to describe the epidemiology, clinical features and survival of this group of neoplasms.

      Method

      This is a retrospective analysis of patients diagnosed with lung NETs between 2010 and 2014 at Instituto Nacional de Enfermedades Neoplasicas (INEN) in Lima, Peru. Demographic characteristics, possible predisposing factors, histological type and stage were collected from clinical files. Survival analysis was calculated with Kaplan-Meier method. Prognostic factors were analyzed with Cox regression method.

      Result

      We identified 69 patients with lung NETs, which corresponds to the 2.8% of lung cancers diagnosed in the same time period. Median age at diagnosis was 62 years and 59.4% of patients were male. Possible risk factors described were smoking history (50%) and familiar history of cancer (23.2%). Mean time from onset of symptoms to diagnosis was 3 months. Frequent symptoms at diagnosis were cough (75%), chest pain (59%), dyspnea (50%), weight loss (49%), hemoptysis (28%), hyponatremia (19.6%) and superior vena cava syndrome (13.8%). Between NETs, SCLC was the most common histological type (82.8%), followed by typical carcinoid (12.1%) and large cell neuroendocrine carcinoma (5.2%). Almost all patients (91.8%) had unresectable disease at diagnosis (21.3%, stage III; 70.5% stage IV) according TNM classification. Among SCLC, 60.4% had an extensive disease according to the IASLC classification, with extra thoracic compromise in bone (25.6%), brain (23.1%), suprarenal gland (21.1%) and liver (15.8%). The preferred systemic treatment was cisplatin/etoposide (93%) in the metastatic setting. The median overall survival for all histological types was 6.7 months (range 4.1 – 9.2) (Differences by histological grade in Table 1). Among clinical factors, weight loss at diagnosis emerged as a prognostic factor associated with survival of high-grade NETs (HR 3, 95% CI 1.6 – 5.5).

      I

      II

      III

      IV

      mOS

      Carcinoids

      40%

      0%

      30%

      30%

      87m (40.4 – 133.6)

      High-grade NETs

      8.8%

      0%

      21.1%

      70.2%

      4.5m (2.6 – 6.4)

      Conclusion

      Lung NETs have a heterogenous clinical presentation with unresectable disease at diagnosis in almost all cases. SCLC is the most frequent histology, however, this proportion regarding of the total cases of primary lung neoplasms is markedly lower than what is reported in the literature, probably to our lower frequency of smokers. The survival of this group of patients is poor in comparison to other series being weight loss at diagnosis an important prognostic factor in this series.

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    P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.16-25 - Epidemiology of Advanced Lung Cancer in Peru (ID 2855)

      10:15 - 18:15  |  Author(s): Katia Roque Perez

      • Abstract

      Background

      Epidemiology and survival data of lung cancer is scarce in Latin America. This information is essential to understand the regional burden that cancer represents and to design and implement targeted interventions for cancer control. Similarly to what happens in the rest of the world, most of our lung cancer patients present with advanced disease.

      Method

      Retrospective analysis of metastatic lung cancer cases diagnosed at Instituto Nacional de Enfermedades Neoplasicas (INEN) Lima-Peru between 2010 to 2014 were reviewed. Data was manually curated from clinical files.

      Result

      993 patients were included, corresponding to 85% of total lung cancer cases diagnosed within the same time period. Median age at diagnosis was 63 years old (range 20-91y) and 55% were females. 25% of patients had history of exposure to biomass fumes from cooking inside the house and 20% of patients were smokers. The histologic type was adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma and large cell carcinoma in 89.2%, 9.8%, 0.8% and 0.2% of the cases, respectively. The adenocarcinoma/squamous cell carcinoma ratio was 9/1. With a median follow-up of 78 months, median overall survival (OS) was 7 months. Median OS for adenocarcinoma, squamous cell carcinoma and adenosquamous carcinoma was 7, 6, and 5 months, respectively.

      Conclusion

      The epidemiological profile of lung cancer in Peruvian patients is unique as it is characterized by a younger age at presentation, a preponderance of females over males and a strikingly high frequency of adenocarcinomas. This may be in concordance with the low prevalence of tobacco smoking and the high prevalence of EGFR mutations previously reported for our population as well as with special exogenous exposures. The low survival could be partially attributed to the lack of access to targeted therapy during those years. The molecular characterization of this cohort of patients is ongoing.