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M. Malafa
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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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P3.02-025 - Therapeutic Lung Resection in Biliopancreatic Cancer Patients (ID 2930)
09:30 - 09:30 | Author(s): M. Malafa
- Abstract
Background:
Of the major malignancies, carcinoma of the pancreas and the distal biliary duct are the most lethal, primarily because the diagnosis is usually made at an advanced stage and the cancer is relatively resistant to therapy. Occasionally, pancreatic cancer presents as a relatively indolent disease and localized blood-borne lung metastases may be solitary and potentially resectable for therapy. As well, some lung lesions that develop may represent another disease unrelated to the pancreatic cancer and may be treated with surgical resection. Therefore we reviewed our experience with therapeutic lung resections in pancreatic cancer patients.
Methods:
We performed a retrospective, case-control study of treated pancreatic cancer patients who underwent subsequent therapeutic lung resections from 1998-2015. All clinical and pathologic data were gathered for comparison in patients undergoing pancreatic pulmonary metastasectomy and those undergoing lung resection for other diseases. Kaplan-Meier (KM) analyses of survivals were calculated.
Results:
25 patients with treated biliopancreatic cancer underwent lung resections with curative intent. 13 patients (mean age 60.2 ± 10.7 years) had resection of isolated biliopancreatic cancer metastases. 11 patients had 12 resections of primary lung cancers (all Stage I) and 1 patient had resection of active Cryptococcus granulomas (mean age 70.8 ± 7.0 years). A smoking history was present in 77% of metastasecomy patients and 67% of lung cancer resection patients. All never-smokers with lung cancer were females. There were no surgical complications or operative mortalities. The median times from pancreatectomy to pulmonary metastasectomy was 29 months (range 0-64), and 12.5 months (range 0-108) for the lung cancer resection group. During the study period, 11/25 (44%) patients died, although only 64% of the deaths were related to pancreatic cancer recurrence. The KM median survivals after lung resection in the pulmonary metastasectomy group was 28 months (range 3-76) and 78 months (range 2-81) in the lung cancer resection group (see Figure). Figure 1
Conclusion:
Although biliopancreatic cancers have an overall dismal prognosis with just a 12.7 month median survival, 40% present with potentially resectable disease. The lung is the primary site of recurrence after resection of the primary biliopancreatic cancer. Based on our experience, we recommend considering pulmonary metastasectomy in highly selected patients who present with no evidence of disease elsewhere. Pulmonary resection can be done safely in this patient population. Additionally, not all new lung masses in pancreatic cancer patients are metastases, and resection should be considered, whenever feasible, for often we find a second primary lung cancer.
