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K. Kaynak



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    P2.12 - Poster Session 2 - NSCLC Early Stage (ID 205)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.12-020 - The Impact of Adjuvant Therapy in Resected Patients with Early Stage Non-Small Cell Lung Carcinoma: The ERCC1 and EGFR Expressions are Associated with Survival. (ID 2924)

      09:30 - 09:30  |  Author(s): K. Kaynak

      • Abstract

      Background
      The aim of study was to investigate the impact of is searching effect of tumor ERCC-1 and EGFR expression levels on survival, metastasis and recurrence in patients with non-small cell lung cancer (NSCLC) who had undergone resectional surgery followed by adjuvant chemotherapy.

      Methods
      In this study, 140 patients with NSCLC who underwent resectional surgery between 2005 and 2009 were analyzed. The patients’ pTNM were constructed according to latest staging system and the specimens were analyzed by both conventional histopathological analysis (hematoxylin-eosin) and immunohistochemical staining for ERCC-1 and EGFR expression. Survival analysis was calculated according to Kaplan-Meier method.

      Results
      Thirtysix (25%) of patient had EGFR expression wheras and 98 (68%) patients were negative for EGFR. The 5-year survival rates of patients with or without EGFR expression were 52% and 54.8% respectively (p=0,717). In patients who had not adjuvant chemotherapy, the 5-year survival rates were 46.7% and 82.1% in patients with EGFR+ and EGFR- tumors respectively (*p=0.035). Tumor ERCC-1 expression level were evaluated in 128 patients. It was found that in 88 patients (61.1%) tumor showed ERCC-1 expression whereas no ERCC-1 expression was found in 40 patients (27.8%). We also found that 5-year survival rate was 65.2% in patients who had ERCC-1(+) tumors while it was 46.1% in patients with tumors not expressing ERCC-1(p=0.047).

      Conclusion
      ERCC-1 expression in tumor tissue seemed to be a good prognosticator in resected non-small cell lung cancer patients. On the other hand, EGFR expression indicated poor survival in these patients. Further studies are needed to clarify this issue.

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    P3.07 - Poster Session 3 - Surgery (ID 193)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P3.07-039 - Video-assisted mediastinoscopic lymphadenectomy is associated with better survival than mediastinsocopy in patients with operable and inoperable non-small cell lung cancer patients. (ID 2934)

      09:30 - 09:30  |  Author(s): K. Kaynak

      • Abstract

      Background
      Video-assisted mediastinoscopic lymphadenectomy (VAMLA) has been developed to reduce the false-negativity rate of mediastinoscopy. We aimed to analyze the impact of VAMLA on survival in patients with operable IA-IIIA disease and inoperable IIIB (N2) tumor.

      Methods
      Between May 2005 and June 2013, 421 N2 patients with non-small cell lung cancer who had undergone standard mediastinoscopy or VAMLA were evaluated. Of these, 105 patients (24.9%) underwent VAMLA, whereas 316 patients (75.1%) underwent standard mediastinoscopy. The median number of resected lymph node was 29.1 in VAMLA group , while the median was 10.3 in mediastinoscopy group.All patients with N2 disease were referred to medical oncology and/or radiation oncology departments. The survival rates were calculated using Kaplan-Meier test. Of those, 26 patients (6.2%) were referred to neoadjuvant treatment.

      Results
      The 5-year survival rate of N2 patients who had VAMLA was 34.0%, whereas it was 18.0% in patients who underwent mediastinoscopy (p=0.03)in all patients. Survival analyses revealed T factor (p=0.04), N factor (p=0.01), multiplicity of nodal status(p=0.04), and lymphatic invasion (p=0.03), type of mediastinoscopy (VAMLA vs standard mediastinoscopy) statistically significant in entire study population. Multivariable Cox analysis confirmed N stage(p=0.01, hazard ratio, 4.1, 95% confidence interval;1.125-8.661)T stage (p=0.045, hazard ratio, 1.4, 95% confidence interval: 1.050-4.112)and type of mediastinoscopy as independent prognostic factors (p=0.02, hazard ratio, 2.1; 95% confidence interval:1.11-11.03)

      Conclusion
      VAMLA seemed to provide longer survival in operable and inoperable (T3-4N2) non-small cell lung cancer patients. This effect could be due to complete resection of mediastinal lymph nodes. Further studies in order to clarify the possible survival impact are warranted.