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Levent Cansever



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    P2.18 - Treatment of Locoregional Disease - NSCLC (ID 191)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Locoregional Disease - NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.18-14 - The Role of Surgery in High Grade Neuroendocrine Tumors of the Lung (Now Available) (ID 2239)

      10:15 - 18:15  |  Author(s): Levent Cansever

      • Abstract
      • Slides

      Background

      Despite early stage operated lung cancer’s better prognosis , high grade neuroendocrine carcinoma (HGNC), including small cell carcinomas and large cell neuroendocrine carcinomas, are rapidly progressive and most cases are inoperable when they are diagnosed ( 1 ). The aim of this study is to evaluate the surgical results of HGNCs and try to define what factors influence the prognosis.

      Method

      Data was collected retrospecively between the years of january 2009 through December 2017 at Yedikule Hospital for Chest Disease Hospital. Clinical survey has ended in january 2019 . During this period 3946 elective lung cancer operations were performed. Patients with exploratory thoracotomy, neoadjuvan treatment and who lost follow-up were excluded from the study. Seventy-one patients operated for HGNC durig this period were enrolled the study. Sixty-five of them had anatomical resection. The ratio of anatomically resected HGNC to over all anatomic cancer resections was 65 over 3946 (1.64%). Twenty-four of 71 cases were HGN small cell (%33.8) and thirty-five of 71 ( %49.3) of the cases were HGN large cell carcinomas. The remaining 12 cases (%16.9) were combined carcinomas.Thirty-one of 71 tumours were T1 ( 43.6% ). Pre-oprerative diagnosis rate in patients with T1 tumors, is 29%.

      Result

      Thirty-one of the patients were in stage I ( 43.6% ), twenty-three of the patients were in stage II ( 32.3% ) and seventeen of the cases were in stage III ( 24.1% ). Subgroups of the stages are shown at table I.Overall survival was 60.75 ± 6.93 months when all operated patents were concidered. Five-year -survival was 44.3% .When overall survival were compared by stage there was statistically significant difference. Overall survivals were as follows; in stage I- 67.03±10.86 months, stage II 61.43±10.83 months, stage III- 33.23±8.6 months (p=0.02) ( Figure I). Five-year survival were 46% in stage I, 45% in stage II, 32% in stage III for HGNC. When overall survival were compared by histopathologic type, combined neuroendocrine carcinomas reflect the least overall survival value but the difference is not statistically significant. Overall survivals were as follows; in large cell neuroendocrine carcinoma- 59.4±9.23, small cell neuroendocrine carcinoma carcinoma 68.6±12.2 combined type neuroendocrine carcinoma- 40.9±10.1 months (p=0.462) (Figure 2). There is no statistically significant difference betwen small cell and large cell neuroendocrine tumours’ overall survival values (p=0.34).When overall survival were compared by N status, overall survival were as follows. Patients with N0 disease 65.9± 8.3, N1 disease 53.6±10.6, N2 disease 37.1±15.3 months. There was no statistically significant difference (p=0.103) (Figure 3). When N0 and N2 patients’ survivals are compared p value is 0.094.

      Conclusion

      Although high grade nuroendocrine tumors (NET) of the lung have poor prognosis compared with other NSCLCs ( 11,12,13 ), satisfactory survival results are asessed in our study.

      As a result, good overall survival rates can be achieved in surgically operated patients with HGNEC tumors who had post- operative adjuvant chemotherapy, mediastinal radiation therapy when necessary and protective cranial radiotherapy. Nevertheless, thoracic surgeon should be very selective in patients with stage IIIa HGNEC tumors.

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