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S. Metintas
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P1.04 - Poster Session with Presenters Present (ID 456)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Pulmonology
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.04-011 - Demographic, Clinical and Survival Characteristics of Lung Cancer among Elderly Patients in Turkey (ID 6155)
14:30 - 14:30 | Author(s): S. Metintas
- Abstract
Background:
To determine demographic, clinical and survival data of elderly lung cancer patients.
Methods:
We evaluated 2,637 patients with lung cancer between January 1990 and October 2010. Elderly patients were defined as those 65 years or older. The patients were classified into two groups: younger and older group. The demographic, clinical and survival data of the groups were compared.
Results:
998 (37.8%) patients were in the older group and 1,639 (62.2%) were in the younger group. The female patients rate (9.1% vs 7.8%; p=0.238) and other cancer history (4.4% vs 3.3%; p=0.101), and family cancer history rate (p=0.664) were similar between two groups. Illiterate patients rate (20.1% vs 16.6%; p<0.001), occupational risks (9.2% vs 12.8%; p=0.005), current smoker and exsmoker rate (p<0.001), asbestos exposure rate (p=0.005), COPD prevalence (15.1% vs 8.6%; p<0.001), and two or more comorbidity rate (21.1% vs 10.1%; p<0.001) of older group was higher than younger group. The symptom duration of the groups were 96.4 days and 92.8 days, respectively (p=0.359). Systemic complaints and extrapulmonary intrathoracic spread complaints of older group were higher than younger group (p<0.001 and p=0.025). Karnosfky performance status was lower in older group than younger group (79.3 vs 82.2; p<0.001). Radiological findings of asbestos exposure was higher in the older group than younger group (6.9% vs 4.1%; p=0.002). There was no difference between the groups in terms of histology and stage (p=0.078 and p=0.254). The independent etiological risk factors of lung cancer in elderly patients were lower educational status, smoking, COPD and male gender by multivariable logistic regression analysis. The median survival was 8.0 ± 0.36 months (95% CI: 7,288-8,712) for older group and 9.0 ± 0.27 months (95% CI: 8,477-9,523) for younger group (log-Rank: 4.567; p=0.033). The factors affecting survival in the both groups stage, Karnofsky performance status and treatment by Cox regression analysis.
Conclusion:
These data indicate that lung cancer had different risk factors and short survival in elderly patients. These features should be considered in the management of these patients.
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P2.06 - Poster Session with Presenters Present (ID 467)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Scientific Co-Operation/Research Groups (Clinical Trials in Progress should be submitted in this category)
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.06-044 - Frequency of Mutations and Related Factors in Lung Adenocarcinoma Cases in Turkey (ID 5291)
14:30 - 14:30 | Author(s): S. Metintas
- Abstract
Background:
Epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 receptor tyrosine kinase (ROS1) gene mutations in lung adenocarcinoma (LA) cases give an opportunity to use some of targeted therapy agents. The aim of this study is to obtain EGFR, ALK and ROS1 gene mutation frequencies in Turkey and to examine the factors affecting these frequencies.
Methods:
EGFR, ALK, ROS1 mutation analyses were examined in a total of 971 LA cases; 745 men (76.7%), and 226 women (23.3%) diagnosed in 12 hospitals from different districts of Turkey were enrolled in the study. The demographic characteristics, smoking status, asbestos exposure history, radiological findings associated with asbestos exposure (AE) were investigated with relation to the frequencies of EGFR, ALK and ROS1 gene mutations. In the univariate analysis of the study data chi-square and t-tests were used. To determine the independent factors associated with gene mutations, multivariate logistic regression model was created with the variables that give p <0.10 level of significance in univariate analysis.
Results:
The mean age of 971 patients was 60.8±9.8 years (range:23-91). Smoking rate was 92.6% in men, 42.5% in women (p<0.001). The number of patients with AE history was 279 (28.7%) and the number of patients with radiologic findings associated with AE was 114 (11.7%). The frequencies of EGFR, ALK and ROS1 mutations were 15.9% (152/956), 3.3% (26/768) and 1.6% (6/379), respectively. Female patients were more likely to have EGFR mutations compared with male patients (37.8% versus 9.3%; p<0,001). Never-smokers had higher incidence of EGFR mutations than smokers (39.6% versus 10.3%; p<0.001). The patients with radiological findings of AE had a 24.6% rate of EGFR mutations compared with a 14.7% rate of patients with no radiological findings (p=0.007). ALK rearrengement was detected in patients with younger age, having history of AE or radiological findings associated with AE (11.1%; p<0.001, 5.9%; p=0.014, 6.7%; p=0.044, respectively). No associated factor was found with ROS1 fusion frequency.
Conclusion:
To have a relationship between radiographic findings associated with AE or AE history and EGFR and ALK mutation frequencies is an original finding. The obtained results will be useful in the discussion of standards of treatment with the new agents and pathogenesis. *This study was carried out through the project named as “Network cooperation for the management of environmental and occupational exposure to mineral fibers induced pulmonary pathologies” which was supported by General Directorate of Health Researches, Republic of Turkey, Ministry of Health.
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P3.03 - Poster Session with Presenters Present (ID 473)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.03-039 - Prognostic Biomarkers for Malignant Pleural Mesothelioma Treated with Chemotherapy (ID 5616)
14:30 - 14:30 | Author(s): S. Metintas
- Abstract
Background:
Prognosis of Malignant Pleural Mesothelioma (MPM) is poor and median survival is about 12 months. If any associations can be established between biomarkers and MPM, there will be benefit to clinical practice. In this study, the aim is to examine expression levels of the genes selected from relevant literature and utilizing in silico methods in the determination of prognosis of MPM.
Methods:
The study group consisted of 54 MPM patients treated by chemotherapy. The expression of 6 genes; sestrin 1 (SESN1), laminin subunit alpha 4 (LAMA4), midkine (MKN), fibulin-3 (EFFL-3), syndecan-1 (SOC-1) and hyaluronan-2 (HYA-2) were examined by qPCR in the tumor tissues. SESN1 and LAMA4 were identified using an in house R based script “Unsupervised Survival Analysis Tool." MKN, EFFL-3, SOC1 and HYA-2 were determined according to existing literature. We used two housekeeping genes; glucose-6-phosphate dehydrogenase (G6PD), TATA-box binding protein (TBP) as controls. qPCR Relative quantification of gene expression was based on the geometric mean G6PD, TBP. The relation between gene expression and prognosis was determined by categorizing samples into two groups using all possible cut-off values, analyzed by the Log Rank test (Log-rank test with multiple cut-offs). Cut-offs generating a p value less than 0.05, between %10-90 percentiles were considered significant.
Results:
Mean age of study group was 62.5± 9.7 years (r:36-82). Of the patients, 43 (79.6%) had epithelioid cell type mesothelioma. The median survival (MS) for all patients was 10 (±1.18 SE) months (CI 95%;7.69 to 12.30). Twenty-five patients (46.3%) survived less than 12 months, 29 (53.7%) more than 12 months, and 4 (7.4%) were still surviving at the end of the study. The clinical factors that was associated with survival were histopathology (p=0.004) and stage (p=0.036). MKN, EFFL-3, SOC1, HYA-2, SESN-1 were found to be associated with survival time by univariate analyses. After the correction with histopathology and stage, MKN (p=0.041), SOC1 (p=0.015), HYA-2 (p=0.003), SESN-1 (p=0.028) were found to be related with survival time. Additionally, in only epithelioid type MPM patients, HYA-2 expression was found to be related with survival time according to multivariate analyses (p=0.016).
Conclusion:
High MKN expression is potential biomarker of poor prognosis and high SOC1, HYA-2, SESN-1 expressions are potential biomarkers of good prognosis in MPM patients, and should be further investigated. High HYA-2 expression also can be utilized as good prognosis biomarker for epithelioid type MPM. *This study was partly supported by General Directorate of Health Researches, Republic of Turkey, Ministry of Health.
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P3.07 - Poster Session with Presenters Present (ID 493)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Regional Aspects/Health Policy/Public Health
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.07-017 - Joinpoint Regression Analysis of Lung Cancer Mortality, Turkey (ID 4939)
14:30 - 14:30 | Author(s): S. Metintas
- Abstract
Background:
It is important to investigate the variation of the deaths due to lung cancer in time.The aim of this study is to investigate the variations in the rate of deaths due to lung cancer in Turkey.
Methods:
Data on lung cancer mortality during 2009-2014 years were extracted from the Turkish Statistical Instıtute and Turkey Public Health Agency mortality data based on Internal Classification of Diseases 10(ICD-10)codes C32-C34.For each gender, age group-spesific and standardised rates were calculated by direct standardized method (using the world standard population).These were expressed as rates/100,000 persons.The temporal trend in lung cancer mortality rates were tested for age,gender and methods using Joinpoint Regression Analysis.In joinpoint regression analysis,the best-fitting points where the rate changes significantly (increase or decrease) are chosen.Each joinpoint indicates a statistically significant change in trend,and annual percentage change(APC) is computed for each of trend by means of generalised lineer models assuming a Possion distrubition.
Results:
119.778 deaths due to lung cancer were recorded; 85.50%(n=102409) of the were in men,14.50% (n=17369)were in women. The mean of crude rate of lung cancer mortality is from 2009(23.77 deaths/100.000) to 2014(26.78 deaths/100.000) 26.19 in 100.000, in men 44.00 in women 7.74.The mean of lung cancer age-spesific standardised rates from 2009(49.47 deaths/100.000)to 2014(54.57 deaths/100.000) is 52.50 in 100.000,in men 45.83 and in women 6.62. Lung cancer mortality rates shows a significant increase between 2009-2014.The rates of lung cancer mortality,between 2009-2014 with 4.2% (%95 Confidence Interval: 3.2 to 5.3)showed an important increase annually(p<0.001).During working period, throughout men the variation 4.1%(2.8 to 5.5)in the lung cancer mortality rates were significant(p<0.001).Similar situation was in women with 5.0%(3.7 to 6.4)(p<0.001)The deaths due to lung cancer in young age(under 44 years )in women(5.27%)is more than men(2.59%)(p<0.001). The decrease of -5.4%(-1.5 to 5.3)in deaths due to lung cancer seen in young men(under 45 years) within years was not significant(p=0.20). Similarly in women with same age the variation 3.1%(-2.7 to 9.3 was not significant(p=0.30). The variation in men between the ages45-64 deaths due to lung cancer within years 1.5%(-0.3 to 3.4)was not significant(p=0.10).Unlike in women in this age group with 3.8% increase(2.2-5.5)showed significance(p<0.001). The increase in deaths due to lung cancer seen in men in 65 years of age and over 4.4%(3.6-5.2)was significant(p<0.001).With the same result in women 2.6%increase(1.1-4.1)was seen(p<0.001).
Conclusion:
Even though deaths due to lung cancer show non-significant decrease in male, shows significantly increase above 65 years of age. Increase in lung cancer in young women is remarkable.
