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J.T. Kaifi
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-018 - The Impact of the Resection Margin on Recurrence and Survival in Bronchopulmonary Carcinoids (ID 2411)
09:30 - 09:30 | Author(s): J.T. Kaifi
- Abstract
Background:
Complete surgical resection is the treatment of choice in bronchopulmonary carcinoids. Previously published data showed no inferiority of sublobar versus lobar resection. Data on the extent of resection margins are lacking, thus we aimed to analyze resection margins in pulmonary carcinoids and correlated them with survival and recurrence.
Methods:
We retrospectively analyzed 85 patients that underwent surgery for atypical (AC) or typical (TC) pulmonary carcinoids. Patient charts were reviewed and clinicopathologic and survival data was collected. Pathology reports were reviewed for length of resection margins.
Results:
The median follow-up period was 42.3 months (range 0.3 - 172.2). There was no statistically significant difference in disease-free survival (DS) when comparing resection margins ≤2 mm to >2 mm (p=0.93, Hazard Ratio (HR)=1.7). When looking at AC alone, a worse DS can be seen if the resection margin was smaller than 2 mm (p=0.06, HR=15.8). In AC likelihood of recurrence was higher when the resection margin was ≤1 cm (Odds ratio=5.1, p=0.28). In TC this tendency was not present (Odds ratio=1.2, p=1).
Conclusion:
There is a trend towards a worse prognosis and higher likelihood of recurrence in smaller resection margins in AC in contrast to TC. Due to low sample size no definitive statements can be made based on this study, however respective data on these rare tumors cannot be drawn from tumor databases. The resection margin is the most critical issue for the treating surgeon and any information on this topic is of highest importance to the field.
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P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-027 - Surgical Salvage Resection for Local Recurrence after Stereotactic Body Radiotherapy for Primary and Metastatic Lung Tumors (ID 2600)
09:30 - 09:30 | Author(s): J.T. Kaifi
- Abstract
Background:
Stereotactic body radiation therapy (SBRT) is an alternative to surgery for the treatment of early stage lung cancer or solitary metastasis in high-risk individuals. The aim of the study was to identify patients that underwent surgical resection as a salvage therapy for local recurrences following SBRT.
Methods:
In a single institution prospective database patients that underwent SBRT for early-stage NSCLC or pulmonary metastatic tumors were identified over 5 years. Patients that underwent surgical salvage resection for local recurrences after SBRT were analyzed for clinicopathological data and outcome.
Results:
In 4/188 (2.1%) patients salvage surgery was performed for local recurrences after SBRT within a median period of 14.5 months. SBRT was performed with a total dosage of 35 Gy in 3 and 37.5 Gy in 1 patient. No perioperative mortality occurred after salvage resection, and complete resection was achieved in all cases. Histopathology demonstrated viable tumor cells accompanied by fibrosis and necrosis in all resected specimens.
Conclusion:
Salvage surgery should be considered in operable patients after lung SBRT for primary and metastatic tumors as viable tumor can be expected. It can be performed safely in appropriate candidates that need to be identified in a multidisciplinary setting. Further analysis of larger series could further clarify true incidence of local recurrences after SBRT and selection criteria for salvage surgery in this challenging group of patients.
