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G. Cetinkaya



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    P1.03 - Poster Session with Presenters Present (ID 455)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Radiology/Staging/Screening
    • Presentations: 1
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      P1.03-017 - Does PET/CT SUVmax Value Correlate with Long-Term Survival in Patients with Surgically Treated Stage I Non-Small Cell Lung Cancer (ID 5786)

      14:30 - 14:30  |  Author(s): G. Cetinkaya

      • Abstract

      Background:
      Positron emission tomography (PET/CT), which detects the biologic activity of tumor cells is routinely used in staging of non-small cell lung cancer (NSCLC). However, the role of PET/CT in predicting disease free long-term survival of surgically treated stage I NSCLC is not clear. In this study, we aimed to investigate prognostic value of metabolic uptake (SUVmax) of the tumor in patients with surgically treated stage I NSCLC

      Methods:
      Two-hundred and sixty patients who had preoperative PET/CT and pulmonary resection for stage I NSCLC between 2005 and 2015 were included into study. The patients were devided into four groups according to the SUVmax value, 0-5, group 1, 5-10 group 2, 10-15 group 3 and over 15 group 4. Lung resection, segmentectomy/lobectomy, was performed within 30 days of PET/CT in all patients. Tumor SUVmax and other potential prognostic variables were chosen for analysis in this study. Patients univariate and multivariate analyses were conducted to identify prognostic factors associated with long-term survival.

      Results:
      There were 53 females and 207 males with a mean age of 61,5 (range 20-84). The mean SUVmax value of the tumors in PET/CT was 10,1 (1-48). The type of the lung resection was segmentectomy in 33(12,7%) and lobectomy in 227(87,3%). Pathologic staging of the tumor was stage 1A in 156(60%), and stage 1B in 104(40%). Median follow-up time was 44 months, and overall 5-year survival rate was 81,7% and there was no statistically significant difference between the groups (p=0,3). SUVmax value of the tumor was not effected by age, gender, tumor type and location (peripheral or central)(p>0,05). However, it was found that the SUVmax value significantly increased along with tumor size (p<0,05. ). Logistic regression analysis revealed that, there is an association between perineural invasion and SUVmax value of the tumor (p=0.049).

      Conclusion:
      Although the previous studies revealed correlation between higher SUVmax values and impaired long term survival, this study revealed no correlation between SUVmax values and long term survival in patients with surgically treated stage I NSCLC. However, tumors with higher SUVmax values have higher chance of perineural invasion. Further studies for possible relationship between metabolic activity and histopathologic characteristics of the tumors are warranted.

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    P1.08 - Poster Session with Presenters Present (ID 460)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P1.08-059 - Timing of Surgery after Induction Chemoradiation Therapy for Locally Advanced NSCLC (ID 5695)

      14:30 - 14:30  |  Author(s): G. Cetinkaya

      • Abstract

      Background:
      The timing of surgery after induction chemoradiotherapy (ChRT) for locally Advanced NSCLC is accepted crucial because of technical difficulties, morbidity and related mortality. Although six to eight weeks’ time interval between induction ChRT and surgery is advocated, precise analysis of the optimal waiting time that maximizes oncologic benefits of ChRT has not been established. We aimed to review our results of pulmonary resections performed after induction ChRT and to determine the effects of time interval on postoperative morbidity, mortality and long term survival.

      Methods:
      We retrospectively reviewed our records for patients undergoing induction ChRT between 1996 and 2015. Timing of treatment was defined as the difference between the last date of radiotherapy and the date of lung resection. The dose of radiotherapy varied from 45Gy to 66Gy. The patients were divided into two groups, surgery less than eight weeks (Group 1) and more than eight weeks (Group 2) following induction ChRT. Type of resection, postoperative complications, 90-days mortality and long-term survival were analyzed. The impact of surgical timing on outcomes was studied through univariable and multivariable analyses.

      Results:
      One hundred and forty-two patients were included into study. The mean time interval between ChRT and surgery was 92.3 days (21-900 days). Sixty-five lung resections were performed less than eight and 77 more than eight weeks. Pulmonary resections were classified as pneumonectomy in 20 patients, lobectomy in 122 patients (of whom, 55 underwent extended resections, chest wall, sleeve etc.). Final pathological examination revealed complete response in 43 (30.3%) of the patients. Major morbidity was observed in 42.2% of the patients [43% (28 of 65pts) in group 1 and 41.5% (32 of 77pts) in group 2, p=0.85]. The overall 90-day mortality rate was 6.3% [7.7% in group 1 and 5.2% in group 2, p=0.54]. The mortality rate after pneumonectomy was 5% (1/20) and 6.5% (8/122) after lobectomy. The 5-year survival rate was 61% vs 47% (p = 0.16). Multivariate analysis showed that timing of surgery after ChRT was not significantly associated with an increased morbidity and mortality that was also not effected by the dose of radiotherapy.

      Conclusion:
      These findings indicate that lobectomy or pneumonectomy can be safely performed eight weeks or more after induction ChRT without affecting surgical morbidity and mortality. Pulmonary resection may be performed safely even one year after ChRT.