Author of

• 10643

  +

  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10647

    +

    P1.07-004 - Multimodality management and surgical outcomes following post neo-adjuvant chemotherapy, radical chest wall resection and reconstruction for PNET chest wall (ID 668)

    09:30 - 09:30  |  Author(s): P. Ramanathan
    • Abstract

    Background
    Primitive neuroectodermal tumor (PNET) is a rare undifferentiated and highly aggressive tumor , most commonly arising in chest wall in teen age patients. Treatment of these patients is challenging and multimodality treatment had a major impact on their outcome. We present our experience of post neo-adjuvant chemotherapy , radical chest wall resection and reconstruction and surgical outcomes.

    Methods
    A retrospective review of a prospectively maintained computerized database of patients was performed and patients with histologically proven chest wall PNET undergoing surgery were identified and analyzed for clinical profile , surgical details and peri-operative outcomes.

    Results
    A total of 71 patients had surgery for chest wall tumor between 2000 to 2009. Fifteen out of 71 were diagnosed as having PNET chest wall. The mean age of presentation was 21 years (15 - 30 years) and there was a slight male preponderance (1.16 : 1). Most common presenting symptom was chest wall swelling and pain. Mean pre chemotherapy tumor size was 20cm. As per our institutional protocol , all patients received neoadjuvant chemotherapy comprising VAC + IE regime followed by surgery. The number of resected ribs ranged from 2 to 5 and the mean chest wall defect was 15cm. Majority required resection of adjoin pleura and in 5 patients segment of adherent lung was resected. A composite chest wall reconstruction was performed using bi-layered synthetic mesh and latissimus dorsi (10) , pectoralis major (3) and serratus (2) muscle flaps. All patients had an uneventful post operative recovery and the peri-operative mortality was nil. Six patients had complete pathological response to chemotherapy and 9 patients had residual tumor and were given post operative radiotherapy. At a median follow up of 36 months , 8 patients are alive and disease free.

    Conclusion
    Multimodality management and advances in surgical techniques had revolutionized the approach to chest wall PNET in the recent past. Our experience has shown that radical chest wall resection and composite reconstruction can be accomplished with excellent outcomes even in patients with advanced PNET and post intensive chemotherapy sessions.

• 11595

  +

  P2.07 - Poster Session 2 - Surgery (ID 190)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11626

    +

    P2.07-031 - Locally advanced lung cancer with low nodal involvement and concomitant tuberculosis in a tertiary care cancer centre of India (ID 2805)

    09:30 - 09:30  |  Author(s): P. Ramanathan
    • Abstract

    Background
    Lung cancer generally presents in an advanced stage and tuberculosis(TB) is a common disease in the subcontinent. This study describes locally advanced lung cancer showing low nodal involvement by cancer and concomitant TB.

    Methods
    Retrospective analysis of lung cancer database of Department of Surgical Oncology , BRA IRCH , AIIMS (2012 -2013 ) was performed and 28 cases were identified who underwent surgeries for lung mass. Only primary lung cancers were included. The clinical features , histopathology and management of these patients were analyzed.

    Results
    A total of 1293 cancer patients were operated between 2012 and 2013 in the department of surgical oncology. Out of which 28 patients were diagnosed to have lung mass with an incidence of 2.1%. Lung cancer was common in fifth decade. Predominant in males [M:F - 3.6:1]. Equal incidence of left and right lung. Five had old Koch's disease. Eighteen were smokers and majority were diagnosed to have lung cancer by computed tomography guided tissue diagnosis. Bronchoscopy detected 9 central tumors. All underwent R 0 resection except one case which was unresectable. Majority were in stage III [ 18 cases]but only 2 patients had nodal invovlement. Chest wall was resected in 4 patients with an average of three ribs resected. Final histopathology showed majority of adenocarcinoma [ 12 cases] followed by squamous cell carcinoma [ 8 cases]. Five patients showed features of concomitant TB.

    Conclusion
    Due to high prevalence of TB in this subcontinent , nodal staging in pre-operative imaging assessment might be fallacious. Imaging and positron emission tomography results should be interpreted more cautiously while making surgical decisions regarding operability.