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F.M.A. Abou Elkasem



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    P1.01 - Poster Session with Presenters Present (ID 453)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Epidemiology/Tobacco Control and Cessation/Prevention
    • Presentations: 2
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      P1.01-031 - Does Malignant Pleual Mesothelioma (MPM) Behaviour Differ among Decades? (ID 6210)

      14:30 - 14:30  |  Author(s): F.M.A. Abou Elkasem

      • Abstract

      Background:
      MPM is extremely aggressive and has a long-latency period. Hence, detected at advanced stages resulting in an unfavorable prognosis(1-2years). However,MPM prognosis has been improving over the past few years with availability of better diagnostic and treatment regimens. We aim to compare clinico-pathologic characteristics of old-MPM cases referred to National Cancer Institute(NCI)-Cairo university between( 2002-2003)and new MPM cases(2012-2015)

      Methods:
      Retrospective review of MPM cases presented to NCI..Data regarding demographics, histology, symptoms and signs, tumor staging and CT-findings were obtained from all patients’ records. Pearson's Chi(X2)and Fisher's Exact t-tests were used for statistical analysis.

      Results:
      1)Old cohort(n=100): 100 patients were encountered. Median age was 46years.Males were 59% of cases. 30% has PS1. Asbestos exposure was documented in 74cases. 44cases were smokers, 25cases were industrial-workers. Family history was positive in 12cases.Dyspnea was the presenting symptom in 92cases,chest pain in 83% and tuberculous pleuritis in 2 cases, effusion in all cases, pleural thickening in 80%,tracheal shift to the opposite-side in 23%, T2 represented 41%. Epithelioid subtype 46.6%. Pathological T2= 34%. 2)New cohort(n=194): 194 patients were encountered.Median age was 53 years.Males and females were nearly equally distributed. Epithelioid subtype was 63.4%. Rt-sided lesions were evident in nearly two-thirds of the cases.Pleural thickening was nodular in 131(69.7%)cases. Inter-lobar fissure was thickened in 29.4%. Mediastinal Pleura was affected in 37.1%. Nearly,half of our cases had effusion.Ossification & calcification were detected in 8(4.1%) cases. Contraction of hemithorax was identified in 77(39.7%)cases. Chest wall invasion(CWI)was present in 18(9.3%) cases. Pulmonary nodules were detected in one-fifth of the cohort. Metastases were detected in 9(4.6%)cases(Figure).Figure 1



      Conclusion:
      By comparing both groups, we found that more lymph node involvement(N+), less metastasis(M+),older median age,more females, more epithelial subtype, less pleural effusion presentation, more pleural thickening were detected in group 2(new cases) reflecting better staging ( mediastinoscopy& PET-CT),early detection, more incidence in females and better treatment modalities.

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      P1.01-049 - Predictors of High Grade Toxicity of Chemotherapy among Malignant Pleural Mesothelioma Patients (ID 5784)

      14:30 - 14:30  |  Author(s): F.M.A. Abou Elkasem

      • Abstract

      Background:
      Malignant pleural mesothelioma is an aggressive thoracic malignancy associated with exposure to asbestos, and its incidence is anticipated to increase during the first half of this century. Chemotherapy is the mainstay of treatment, yet sufficiently robust evidence to substantiate the current standard of care has emerged only in the past 5 years.

      Methods:
      A retrospective cohort study of 100 MPM patients referred to NCI, Cairo University in 3 years. Detailed data, Pearson's Chi (x2) square and Logistic regression model were used for statistical analysis.

      Results:
      We found a statistical significant relation between age ( 0.005), male gender (0.002), endemic area residence( 0.001), industrial workers ( 0.018), duration of exposure (0.04), smokers (0.009), Simian virus ( 0.019), P53 ( 0.001), RbP (0.001), PS ( 0.0.16) and development of high grade toxicity of platinum based chemotherapy. Median age = 46 years, only 17% of cases developed high grade toxicity complications of platinum based chemotherapy. Males were 59% of cases. PS, residence, smoking, occupation, history of asbestos exposure, family history, simian virus, P53, Rbp, dyspnea, chest pain, cough, expectoration, haemoptysis, weight loss, fatigue, metastatic symptoms, chronic lung infection, Tuberculous pleuritic, effusion, pleural thickening, Tracheal shift, TNM staging, surgical operations, pathological staging, radiotherapy ,cause of death and chemotherapy toxicity are assessed in our patients.

      Conclusion:
      Many factors predict high grade chemotherapy toxicity. So, search for target therapy and immunotherapy instead of chemotherapy in this selected group can improve both quality of life and response rate.

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    P1.02 - Poster Session with Presenters Present (ID 454)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Biology/Pathology
    • Presentations: 1
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      P1.02-087 - Sensitive Detection of Rare Cancer Cells by Preprogrp-Specific RT-PCR and Its Correlation with Clinicopathological Data and Survival (ID 3802)

      14:30 - 14:30  |  Author(s): F.M.A. Abou Elkasem

      • Abstract

      Background:
      Reverse transcription polymerase chain reaction (RT-PCR) based amplification of transcripts expressed in cancer but not in normal non-neoplastic cells is increasingly used for the sensitive detection of rare disseminated or exfoliated cancer cells to improve cancer staging and early detection protocols. This study aimed to detection of Prepro–Gastrin-Releasing Peptide in peripheral blood in lung cancer patients referred to National Cancer Institute, Cairo University, Egypt. And to identify its relationship with clinicopathological features, prognosis and survival.

      Methods:
      Our study group consisted of 62 newly diagnosed lung cancer cases and 30 healthy volunteers, RNA was isolated from peripheral blood and then the samples were assayed by nested RT- PCR. Pearson's chi (X2) test was used to compare categorical variables. Kaplan Meier curves for survival analysis and Median and range for continuous variables were used for statistical analysis.

      Results:
      Our study included 62 cases of lung cancer (60 males, median age was 57(34-81) years. For clinicodemographic data( Fig.1). Eleven (17%) cases had pleural effusion (stage IV). Seventeen (27%) cases had extensive SCLC, 7 cases had limited SCLC. Fourty-four (70%) cases received chemotherapy, 20 (32%) cases received palliative radiotherapy to bone, brain or mediastinum. Seventeen (27%) had elevated alkaline phosphatase level. Seven (63%) out of the 11 cases with bone metastasis underwent splintage, internal fixation ± bone cement injection to reinforce a bone defect prior to palliative radiotherapy (pRTH). As regard SCLC, 10 (16%) cases received platinum based chemotherapy. One case developed GIII mucositis and one case developed jaundice and PS became III and shifted to best supportive treatment. One case received gamma knife to cerebellar metastasis, one case received palliative RTH to mediastinum and another pRTH to brain before chemotherapy. Twenty-six (41.9%) cases were preprogastrin +ve(53.8% SCLC, 15.4% Squamous cell ca, 15.4%large cell ca, 11.5% adenocarcinoma and 3.8% undifferentiated carcinoma) . Median PFS=3.9 months (2.87-4.96). Median PFS among preprogastrin –ve vs. +ve cases was 4 vs. 3 months. There was a statistical significant relationship between preprogastrin and SCLC with higher number of SCLC among +ve preprogastrin cases (P=0.038). Also, there was a statistical significant relationship between preprogastrin and smoking with many smokers among +ve preprogastrin cases (P=0.010).

      Conclusion:
      SCLC and smoking are significantly correlated with preprogastrin. Median PFS was longer in preprogastrin -ve cases. So detection of circulating tumor cells might be a suitable parameter to identify patients who might benefit from adjuvant therapy. Smoking cessation is mandatory.