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I. Uthman



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    Epidemiology and outcomes (ID 57)

    • Event: ELCC 2018
    • Type: Poster Discussion session
    • Track:
    • Presentations: 1
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      215PD - Survival patterns in patients with malignant pleural mesothelioma using multimodality therapy (ID 525)

      10:59 - 10:59  |  Author(s): I. Uthman

      • Abstract

      Background:
      Malignant pleural mesothelioma (MPM) is no more considered a rare disease and its incidence is escalating. It became a must to develop innovative modalities for better survival rates. Up to date, there is no agreement on the effectiveness of multimodality in MPM patients. This study assesses the value of multimodality therapy and identify the demographic and pathological characteristics associated with better outcome.

      Methods:
      Using SEER database, we extracted the data of 681 patients with MPM from 2004 to 2013. We included all age groups and races, AJCC stages I-IV and all histopathological variants. Patients were divided into four groups according to the received intervention: surgery alone, surgery followed by radiotherapy, surgery and chemotherapy, and triple modality (combination of surgery, chemotherapy, and radiotherapy).

      Results:
      Out of 681 patients, 176 (25.8%) had surgery alone, 74 (10.9%) had surgery followed by radiotherapy, 307 (45.1%) had surgery and chemotherapy, and 124 (18.2%) had a combination of surgery, chemotherapy, and radiotherapy. Highest one-year survival rates were observed among patients had the triple modality (79.6%, p value 0.000) in comparison to surgery alone (37.9%), surgery followed by radiotherapy (70.3%) and combined surgery and chemotherapy (62.2%). There is a statistically significant relationship between receiving the triple modality and each of the race, age, histopathology and nodal involvement.Table:One year survival rates among patients received the triple modality

      VariablesSurvival ratesNP value
      Sex
       Male76.8%970.504
       Female89.9%27
      Age
       20–39100%10.000**
       40–5994.1%31
       60–7976.5%88
       >8026.9%4
      Race
       White79.7%1150.017*
       Black100%3
       Other67.5%6
      Histopathology
       Sarcomatoid15.0%70.000**
       Epithelioid81.9%93
       Biphasic89.1%24
      N Stage
       N077.7%630.02*
       N187.0%35
       N273.7%22
       N3100%3
      AJCC Stage
       II82.4%210.50
       III85.5%57
       IV71.0%46


      Conclusions:
      Survival rates of MPM patients are the highest when receiving combination of surgery, chemotherapy, and radiotherapy. Further investigations are needed to study the long-term outcomes.

      Clinical trial identification:


      Legal entity responsible for the study:
      Mariam Hassan

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      203P - Combined pulmonary metastasectomy and chemotherapy in patients with colorectal lung metastases and concurrent extrapulmonary disease (ID 282)

      12:50 - 12:50  |  Author(s): I. Uthman

      • Abstract

      Background:
      Lung metastases from colorectal cancer (CRC) with the presence of concurrent extra-pulmonary disease is considered a very poor prognosis. Chemotherapy was the only advised treatment. Nowadays with the evolution in surgical oncology techniques, imaging and medical oncology treatment, a better management is present for stage IV colorectal cancer with a prolonged overall survival. We aim to evaluate the benefit of adding surgical resection to chemotherapy in patients with colorectal lung metastasis and extra-pulmonary diseases.

      Methods:
      We extracted the data of 1423 colorectal cancer patients with pulmonary and extra-pulmonary metastases from 2010 to 2013, using SEER database. Ninety-nine (7%) patients had combined chemotherapy and pulmonary metastasectomy, while 1324 (93%) of them received chemotherapy only.

      Results:
      Patients who received combination of chemotherapy and pulmonary metastasectomy had better 1-year survival rates (83.5%), compared to those who received chemotherapy only (68.3%). We observed a statistically significant difference between the two modalities in white patients, patients aged between 40 to 59 years, tumors arising in sigmoid colon or rectum, patients with elevated CEA levels, and those with metastasis to the lungs only or both lung and liver.Table: (Abstract: 203P)

      VariablesCombined TherapyChemotherapyp value (difference in modalitiesp value (difference in combined therapy)
      Sex
       Male79.4%66.6%0.007**0.399
       Female87.1%70.6%<0.001**
      Age
       20–3966.7%77.8%0.2190.201
       40–5989.7%74.2%<0.001**
       60–7973.0%66.2%0.159
       ≥80100%43.2%0.221
      Race
       White86.7%69.3%<0.001**0.687
       Black74.3%65.4%0.061
       Others77.9%66.1%0.036**
      Primary Site
       Cecum76.1%69.0%0.7500.003*
       Ascending Colon70.0%58.0%0.401
       Hepatic0%55.1%0.361
       Flexure Transverse Colon100%55.5%0.605
       Splenic Flexure60.3%59.2%0.937
       Descending Colon75.3%64.3%0.068
       Sigmoid Colon85.5%68.5%0.002**
       Rectum100%74%<0.001**
      Distant Metastasis
       Lung Only94.5%78.9%0.002**0.007*
       Lung and Liver77.4%64.7%0.002**
       Lung and Brain100%25.3%0.198
       Lung and Bone50.8%65.9%0.783
      CEA Level
       Normal95.7%81.4%0.3780.446
       Elevated79.9%66.2%<0.001**


      Conclusions:
      Combining pulmonary metastasectomy with chemotherapy in CRC patients with pulmonary and extrapulmonary metastases shows higher 1-year relative survival rates when compared to using chemotherapy alone.

      Clinical trial identification:


      Legal entity responsible for the study:
      Inas Uthman

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.

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      82P - Chemotherapy versus combined chemoradiotherapy: Survival patterns among patients with extensive disease small cell lung cancer (ID 283)

      12:30 - 12:30  |  Presenting Author(s): I. Uthman

      • Abstract

      Background:
      Extensive Disease Small Cell Lung Cancer (ED-SCLC) represents 30% of lung cancer. While surgery is not an option, chemotherapy is traditionally currently recommended as the standard treatment. As oncologists seek superior modality for better survival, we conducted this study to evaluate the efficacy of combined chemotherapy and thoracic radiotherapy in improving the survival of patients with ED-SCLC, and to identify the characteristics of best candidates.

      Methods:
      Using the SEER database, we extracted the data of 5443 patients with ED-SCLC from 2010 to 2013. There were 2665 (49%) patients who underwent combined chemotherapy and thoracic radiotherapy, while 2778 (51%) of them received chemotherapy only. Patients’ demographics and TNM classification were assessed.

      Results:
      Patients with ED-SCLC had better outcomes when they received combined chemoradiation, compared with those who received chemotherapy alone, where overall 1-year relative survival rates were 40.2% and 24.1%, respectively (p value <0.001). All patients’ characteristics favor combination over chemotherapy except those aged below 40 years and those over 80 years. Subgroup analysis revealed better survival rates among female patients, patients aged between 40 and 59 years, and those with metastasis to the other lung or free regional lymph nodes. On the other hand, no advantage was allocated to those of specific race or primary site.

      Survival of Patients
      VariablesChemoradiationChemotherapyp value
      Sex:
       Male37.1%21.5%<0.001**
       Female43.9%27.0%<0.001**
      Age:
       20–3928.6%80.1%0.914
       40–5943.3%25.0%<0.001**
       60–7940.0%24.3%<0.001**
       ≥8021.8%19.6%0.6
      Race:
       White39.9%23.7%<0.001**
       Black42.5%27.7%0.002**
       Others40.9%25.4%0.002**
      Primary Site:
       Upper Lobe40.3%24.3%<0.001**
       Middle Lobe47.5%22.6%0.001**
       Lower Lobe38.4%23.9%<0.001**
       Overlapping Lesion44.5%25.4%0.01*
      Lymph Nodes Involvement:
       No Nodes Involved53.6%,35.5%<0.001**
       Single Ipsilateral Node46.8%31.6%<0.001**
       Multiple Ipsilateral Nodes37.5%22.3%<0.001**
      Distant Metastasis:
       Lung37.5%,21.0%<0.001**
       Liver30.2%19.2%<0.001**
       Brain31.5%22.4%<0.001**
       Bone31.6%21.2%<0.001**


      Conclusions:
      Combined chemoradiation in patients with ED-SCLC shows higher 1-year relative survival rates when compared with chemotherapy alone. Further studies should be conducted to weigh the efficacy versus safety to consider using chemoradiation as an alternative modality for ED-SCLC.

      Legal entity responsible for the study:
      Inas Uthman

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.