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Mónica Castro
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EP1.05 - Interventional Diagnostics/Pulmonology (ID 195)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Interventional Diagnostics/Pulmonology
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.05-11 - Integrating Radiological Features to CT Guided Lung Biopsy Results; The Experience of an Argentinean University Teaching Hospital (ID 2360)
08:00 - 18:00 | Author(s): Mónica Castro
- Abstract
Background
To analyze the radiological findings and the diagnostic accuracy of percutaneous transthoracic needle biopsies (CT- PTNB) performed for the evaluation of patients with lung lesions derived to our center.
Method
We describe a retrospective review of 206 consecutive patients undergoing CT- PTNB of lung lesions performed between 2016 and 2019 at a single oncological referral center. Clinico-pathological data, including: age, smoking status, and previous cancer was described. Radiologic lesion´s characteristics on CT; multiple or solitary , location, mean diameter (mm), type (mass³30 mm, nodule < 30mm, other), mean distance to pleura, presence of consolidation, nodule edge, calcifications, presence of radiologic emphysema, ground glass component and PET-CT SUVmax were used to compare with lung biopsy results. The rate and factors associated with complications was also be reported.
Result
From 105 patients who underwent CT- PTNB and fulfilled inclusion criteria; 85 (81%) had pathologic confirmed cancer diagnosis, 3 (3%) had benign findings and 17 (16%) had inadequate samples for accurate diagnosis. The majority of patients were: male (57%) and the mean age was 63 years (32–88). Lung cancer was the main diagnosis (49/85; 58%) achieved through CT-PTNB; 71.2% of these cases had adenocarcinoma histology and 29% (14/49) had previous cancer diagnosis (35%: breast cancer) being the majority of them smokers (86%). Metastatic lesions (36/85; 42%) were: 44% melanoma-sarcoma, 38%: breast, colorectal, renal and cervix cancer and 18%: lymphoma, cervix, head and neck, lung and urothelial cancer. Primary lung cancer compared to lung metastases showed on CT images: mass presentation (63%vs33%; p=0.002), right superior lobe localization (47% vs 33%; p=0,016), solitary lesion (77% vs 53%; p=0,016), consolidation (22% vs 5%; p=0,033), central calcification (12% vs 0%; p=0,024), emphysema (55% vs 28%; p=0,009), mean major diameter (mm) (61±33 vs 36±24; p=0,000), mean distance to pleura (mm)(32±78 vs 86±12.7; p=0,014) and PET-CT mean SUVmax (8.8±10.63 vs 4.7±6.8; p=0.045). The complication rate of CT- PTNB was 18.5% (half of them practiced through right upper lung lobe , being pneumothorax the most common. Mean distance between pleura to CT- PTNB site was 10.54 vs 3.81 mm in complicated and non-complicated cases, respectively.
Conclusion
Primary and metastatic lung lesions were safely pathologically evaluated by CT- PTNB. Radiological characteristics of the lesions can help in patient´s initial assessment to predict their nature.
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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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EP1.12-40 - Neuroendocrine Tumors of the Lung: Clinico-Pathological Characterization and Follow-Up of Patients Treated at an Argentinean University Hospital in the Last 10 Years (ID 1152)
08:00 - 18:00 | Author(s): Mónica Castro
- Abstract
Background
Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies that arise from neuroendocrine cells throughout the body, most commonly from the lungs and gastrointestinal tract. Histological characteristics and clinical behaviour define lung NETs, which are classified into four groups: typical (TC) and atypical carcinoids (AC), large-cell neuroendocrine carcinoma (LCNC) and small-cell lung cancer (SCLC). The identification and differentiation of TCs from ACs or LCNECs and SCLC is essential for treatment options and prognosis.
Method
We performed a retrospective review of patients with lung NETs treated in our institution in the last decade. We analysed histological confirmed primary lung NETs cases. Demographics, clinical characteristics, imaging, treatment and outcome are described for this patient population.
Result
A total of 91 patients with lung NETs were included; 28/91 (30.8%) were lung carcinoids (TC:14 and AT: 14) and 63/91 (69.2%) were high grade lung NETs (SCLC: 54 and LCNC: 9). Comparing low and high grade NETs groups of patients, we could identify differences in the following variables: mean age at diagnosis (51±14 vs 61 ±9 years, p=0.000), mean time from the beginning of symptoms to achievement of pathologic diagnosis (10.5±15.9 vs 3.9 ± 2.6 months, p=0.002), ECOG³2 (14% vs 42%, p=0.001), smokers (57% vs 95%, p=0.000), median % of Ki67 expression (4%, (1-30%) vs 50%, (20-90), p=0.000), history of inflammatory lung disease (18% vs 32%, p=0.028) and presence extra-thoracic disease at diagnosis (47% vs 68%, p=0.000). No statistically differences between groups were observed in: sex, family history of lung cancer, second diagnosis of cancer and body mass index at diagnosis. Functioning carcinoid syndrome was observed in 10% (3/28) of patients with lung carcinoids. For the entire cohort, the median overall survival (OS) was 19 months (IC95%: 14-24 months). The five year OS for patients with lung carcinoids was 62% and 13% for high grade NETs.
Conclusion
In our series of lung carcinoids we observed a high frequency of: atypical carcinoids, advanced disease at presentation and smoking history. However, the 5-year overall survival is the expected for this population. More knowledge is needed about this entity in South American countries.
