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A. Charpidou



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    P1.17 - Poster Session 1 - Bronchoscopy, Endoscopy (ID 182)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Pulmonology + Endoscopy/Pulmonary
    • Presentations: 1
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      P1.17-002 - The clinical significance of endobronchial ultrasound in the detection of peripheral pulmonary lesions (ID 339)

      09:30 - 09:30  |  Author(s): A. Charpidou

      • Abstract

      Background
      Flexible fiberoptic bronchoscopy (FB) is the standard of care for the evaluation of pulmonary lesions. The aim of the current study is to investigate the effectiveness of EBUS-guided bronchoscopy compared to blind FB techniques in the study of non-visible pulmonary lesions.

      Methods
      We conducted a one year, retrospective, study comparing two populations: In the first one biopsies were performed conventionally (FB-B) with the help of static CT images and in the second biopsies were performed after EBUS- guidance (FB-EBUS). A 20- MHz radial- type ultrasound probe was used to obtain images. Sampling techniques, like bronchial brushing (BR) and transbronchial biopsies (TBB), were conducted in both populations by two separate bronchoscopists. If not a diagnosis was achieved a surgical biopsy or observation strategy was followed.

      Results
      Forty patients appeared with non visible lesions and were included in this study. Twenty patients were examined with the use of EBUS (FB- EBUS) and in twenty cases a conventional FB (FB-B) was conducted. Moreover left lower lobe was the most promising to obtain a diagnosis using ultrasonographic images.

      Conclusion
      Our results suggest that in patients with a non visible pulmonary lesion or SPNs a diagnostic strategy involving EBUS- guided biopsy techniques is a reasonable and effective choice.

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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P2.07-004 - Wedge Resection and Segmentectomy in Patients with Stage I Non-small Cell Lung Cancer (ID 344)

      09:30 - 09:30  |  Author(s): A. Charpidou

      • Abstract

      Background
      The use of resections lesser than lobectomy as definitive management of a stage I non-small cell lung carcinoma (NSCLC) is a topic that creates controversy in the global medical community. To describe the current conclusions concerning the relative indications of each type of resection in the surgical treatment of stage I NSCLC, as well as the international results from their application concerning the local recurrence, disease-free survival, and five-year survival rates.

      Methods
      Thirty four prospective and retrospective studies registered in PubMed and Scopus electronic databases during the last twenty five years were reviewed. Bibliographies and handsearching of journals were used to identify trials. Studies’ authors, citations, objectives, and results were extracted. No meta-analysis was used. Validation of results was discussed.

      Results
      Segmentectomies were superior to wedge resections in terms of local recurrence and cancer-related survival rates. Sublobar resections were superior to lobectomy concerning preservation of pulmonary parenchyma. It was recommended that high-risk patients undergo segmentectomy. Lobectomies were superior to segmentectomies only for tumors >2 cm (T2bN0M0) as regarding disease-free and overall 5-year survival. There was no significant difference for tumors <2 cm in most studies. Free surgical margins were crucial for local control rates. Systematic lymphadenectomy was mandatory regardless of type of resection. In cases of pure bronchoalveolar carcinoma, segmentectomy was recommended. Shorter hospital stay was achieved with sublobar resections.

      Conclusion
      The choice of type of resection for T1aN0M0 tumors should rely on specific patient and tumor characteristics. Patient age and tumor size are the most important factors. Further prospective randomized trials are needed to determine minimal resections in early lung cancer patients.

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    P3.23 - Poster Session 3 - Tobacco Control, Prevention and Chemoprevention (ID 164)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      P3.23-001 - The clinical significance of smoking cessation in patients with cancer (ID 342)

      09:30 - 09:30  |  Author(s): A. Charpidou

      • Abstract

      Background
      Despite the established causal relationship between tobacco smoking and cancer many cancer patients continue to smoke after diagnosis. This partly reflects the ignorance of the beneficial effects of smoking cessation even after diagnosis. The aim of the study is to demonstrate the effect of continuing or quitting smoking in patients with diagnosed cancer.

      Methods
      This study is based on a review of medical databases (Pub Med CENTRAL, MEDLINE, Cochrane Library) of the last thirty years. All articles included in the present analysis were in English.

      Results
      In patients with early stage lung cancer, continued smoking after diagnosis is associated with an increased risk of all cause mortality and decreased survival. Research has demonstrated significant difference in actuarial overall survival favoring the non-smoking group among patients with lung cancer. In patients with oral cancer smoking cessation or reduction leads to a significant reduction in mortality. There is also evidence that tobacco smoking exacerbates and prolongs radiotherapy induced complications.Of particular importance is the evidence that continued smoking is associated with adverse effects during anticancer treatment. Smoking increases tumor progression and resistance to chemotherapy due to nicotine-induced resistance to apoptosis by modulating mitochondrial signaling. Continuing smoking is also related with inferior outcomes during treatment with novel targeted therapies such as erlotinib. Continuing smoking in gastric and lung cancer patients is also associated with an increased risk of developing second primary tumors. Quitting smoking after lung cancer diagnosis is associated with better performance status while persistent smokers have worse overall quality of life. Patients who continued to smoke despite being diagnosed with cancer report more severe pain than never smokers and a greater interference from pain.

      Conclusion
      Continuing smoking after cancer diagnosis is related with reduced treatment efficacy and reduced survival, risk for more secondary malignancies and deterioration in quality of life.