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M.D. Ter-Ovanesov



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    P1.07 - Poster Session with Presenters Present (ID 459)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: SCLC/Neuroendocrine Tumors
    • Presentations: 1
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      P1.07-022 - The Role of Surgery in Combination Treatment of Patients with Small Cell Lung Cancer (ID 3870)

      14:30 - 14:30  |  Author(s): M.D. Ter-Ovanesov

      • Abstract
      • Slides

      Background:
      Small cell lung cancer (SCLC) as the most aggressive tumor deserves a special attention. The aim of this research was to define the place of surgery of patients with SCLC in order to improve the results of treatment.

      Methods:
      Clinical material for research consists of 46 patients in stage IA-IIIA with SCLC, which were radically operated in Ugra (region Russia) between 1999 and 2013. Among patients predominate males 38 (82,6%), versus females – eight (17,4%).

      Results:
      All patients underwent radical operations R0. All resection types were included (pneumonectomy, bilobectomy, and lobectomy). By 32 patients (69,6%) systematic nodal dissection (SND) was carried out, by 5 (10,9%) - mediastinal lymph node sampling (MLS) and by 9 patients mediastinal node dissection was not carried out. By SCLC combination treatment was used more often – 32 (69,6%). By that only in 8 cases additional adjuvant of thoracic radiotherapy was used. In 14 cases only surgical resection was used (30,4%). 5-year overall survival (OS) rate was 47,1%. Median survival rate was 58 months. Five-year OS rate by surgery combined with adjuvant chemotherapy was 52,1%, as compared to only surgical treatment – 35,6%. At I stage satisfactory results were achieved: 5-year OS rate was 69% (р<0,05), – that corresponds with results of treatment of patients with non-small cell lung cancer with similar stage of process. Median survival rate was not achieved. At II stage 5-year OS rate was 31%. Median survival rate was 46 months. At III stage unsatisfactory results were obtained. 5-year OS rate was 21%. Median survival rate was only 11 months.

      Conclusion:
      SCLC at I and II stages is the indication to radical treatment, mandatory including surgical resection with SND and adjuvant chemotherapy. The main method of treatment at III stage is chemotherapy or chemoradiotherapy.

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    P3.04 - Poster Session with Presenters Present (ID 474)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P3.04-012 - Bronchial Sutures in Anatomic Pulmonary Resections: The Clinical Experience of 865 Cases (ID 3869)

      14:30 - 14:30  |  Author(s): M.D. Ter-Ovanesov

      • Abstract
      • Slides

      Background:
      Although the incidence of bronchopleural fistula (BPF) has decreased in past time, it remains a serious complication following pulmonary resection.

      Methods:
      Between 1999 and 2011, 865 patients with lung cancer underwent radical surgery. 732 (84,6%) males and 133 (15,4%) females were ranging between 22 and 79 years (average 55,2±8,1). We retrospectively reviewed the data for morbidity, mortality and complications, especially with regard to the type of bronchial suture.

      Results:

      Rate BPF from the dependence of the type of bronchial suture
      Type of bronchial suture cases BPF %
      Stapled closure 210 14 6,7%
      Stapled closure with additinal hand suture 514 24 4.7%
      Hand closure 141 1 0,7%
      Total 865 39 4,5%
      All patients underwent radical operations: 286 (33,1%) pneumonectomies, 501 (57,9%) lobectomies and 78 (9,0%) bilobectomies. In postoperative period 39 patients (4,5%) had complication – bronchopleural fistula. After pneumonectomy BPF took place in 33 (11,5%) cases, not differing significantly from the volume of lymph node dissection. After lobectomy BPF occurred statistically significant rare – in 6 (1,0%) cases. It should be noted, that the volume of lymph node dissection not significantly affect the frequency BPF. The most frequently BPF occured after pneumonectomies – 33 (26 on the right, 7 left). After lobectomies BPF occurred in less cases – 6 (2 on the right, 4 left). By using hand closure BPF occurred in 1 out of 141 (0,7%) cases. By using stapled closure – in 14 of 210 (6,7%). By using stapled closure with additional hand suture – 24 of 514 (4,7%).

      Conclusion:
      Thus the safest method of bronchus closure is hand suture. The stapled closure statistically significant increase the amount of BPF (p<0,05).

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