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Margarida Felizardo
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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: 2
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.11-11 - Familial Lung Cancer: A Call for Action (Now Available) (ID 1843)
08:00 - 18:00 | Author(s): Margarida Felizardo
- Abstract
Background
Lung cancer (LC) is the most deadly of all cancers mostly due to the fact that the disease is often detected at an advanced stage with less effective treatment options. While 80% of lung cancers can be directly attributable to tobacco smoking, the disease has been increasing in non smokers raising awareness to other risk factors that could be screened for and controlled in order to achieve higher rates of early stage diagnosis.
Method
A retrospective analysis of the electronic records of LC patients followed in our district hospital between May 2012 and December 2018 was conducted. Patients with family history of cancer were selected and their demographic characteristics, smoking status, co morbidities and LC characteristics were analyzed.
Result
A total of 524 patients were followed, 33 of whom with a positive family history of cancer (20 men and 13 women, median age of 61.7years old at diagnosis +- 12.8 years). Only 9 were never smokers and 63.6% (21) were diagnosed following the investigation of symptoms. The majority (24) had an adenocarcinoma subtype (3 EGFR mutations, 1 ALK translocation and 2 HER2 amplification were identified).
Twenty patients (60.6%) had a family history of LC and the most frequent family member affected were parents (father: 14; mother: 11) and siblings (11). Cancer affected at least 2 family members of 15 patients. At the time of diagnosis 19 of the 20 patients with LC family history had an ECOG Performance Status of 0-1 and 8 (40%) had advanced stage disease.
We found no significant difference in stage at diagnosis, smoking status or symptoms at diagnosis between patients with and without a LC family history of malignancy (p=0,120, p=0,117 and p=0,814 respectively).
Conclusion
Studies demonstrating evidence of familiar aggregation of LC suggest a possible genetic susceptibility to this malignancy. Identification of individuals at particularly high risk of lung cancer due to this type of susceptibility would contribute to early detection and possibly to prevention through targeted and intense anti-smoking efforts. Perhaps due to the small dimension of our study population, our patients were not diagnosed in early stages of the disease despite a positive family history of lung cancer. This raises the question whether this particular group of people should be selected for specific cancer screening to allow for the possibility of curative treatments.
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EP1.11-18 - Follow-up and Recurrence After Surgery in Patients with Non-Small-Cell Lung Cancer (Now Available) (ID 1998)
08:00 - 18:00 | Presenting Author(s): Margarida Felizardo
- Abstract
Background
Lung cancer is one of most common cause of cancer death in the world. Surgery is a potentially curative intervention in early stages of non-small-cell lung cancer (NSCLC), although some patients develop recurrence. Identification of factors related to recurrence is essential to reduce it.
Method
The objectives of this study were to evaluate the follow-up of patients with early stage NSCLC who undergoing surgical resection, as well as, the factors related to recurrence.
We retrospectively evaluated patients with early-stage NSCLC (stage 0-II) who underwent surgical resections between January 2015 and December 2017 at Hospital da Luz – Lisboa. Patients were evaluated at a multidisciplinary lung cancer tumour board team meeting and followed according to international guidelines. We characterised demographic, clinical and radiological features, surgical procedure, histology and follow-up. The mean and standard deviation were shown; the T-student and Fisher tests were used; P value ≤0.05 was considered significant.
Result
There were included 46 resected NSCLC: 41 (89.1%) adenocarcinoma (ADC) – 25 invasive ADC, 11 ADC in situ (Tis) and 5 minimally invasive ADC; 4 (8.7%) epidermoid and 1 (4.2%) pleomorphic carcinoma. Twenty-seven (58.7%) were female and 29(63.0%) were current or former smokers; mean age was 63.1±9.3 years old (37-82).
We underwent 30 (65.2%) lobectomies, 13 (28.3%) anatomic segmentectomies, 2 (4.3%) wedge resections and 1 (2.2%) bilobectomy, all with mediastinal lymph node dissection. No major complications were reported.
Regarding surgical stage, 11 (23.9%) were stage 0, 26 (56.5%) Ia, 7 (15.2%) Ib, and 2 (4.3%) IIa.
Thirty-nine (84.8%) patients were in follow-up or died due to non-lung cancer cause (1 case). The follow-up was 28.7±8.5 (12-47) months. Recurrence was documented in 4 (8.7%) patients; the time of recurrence development was 14.8±9.2 (4-26) months; Second primary lung cancer occurred in 3 6.5%) patients.
Comparing recurrence and follow-up groups, there was only difference regarding age (73.0±7.8 vs 62.4±9.1; p=0.032) - gender (p=1.0), smoking history (p=0.621), nodule characteristics (solid vs sub solid) (p=0.140), lung resection (lobar vs sublobar) (p=0.297) and stage (stage 0/I vs stage II) (p=1.0). All Tis lesions were in follow-up.
Conclusion
In this group with resected early-stage NSCLC, most of the patients were in follow-up and the age was the only factor associated to NSCLC recurrence. Although low recurrence documented, it is essential to perform more accurate patient selection ensuring a radical cure. Probably other variables, as molecular/genetic parameters, can help to identify those with high-risk recurrence and the liquid biopsy can be useful in the detection of lung cancer recurrence.
