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A. Jakhetiya
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 2
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-029 - Surgical Experience of Primary Salivary Gland Tumors of Lung: Experience from Tertiary Care Cancer Center in North India (ID 4992)
14:30 - 14:30 | Author(s): A. Jakhetiya
- Abstract
Background:
Primary salivary gland type tumors of lung (PSGTTL) are rare intra-thoracic malignant neoplasm. Their description in literature is largely limited to a few case series/case reports. We herewith present our surgical experience and review its clinical presentation, management options and survival outcomes.
Methods:
We performed a retrospective analysis of prospectively maintained computerized data-base of lung cancer patients at department of surgical oncology, Dr BRA-IRCH, AIIMS, Delhi. A total of nine patients underwent treatment for PSGTTL during the period from January 2012 to December 2015. Details concerning the clinical presentation, preoperative therapy, operative procedure, histopathological examination, postoperative complications and outcome were retrieved and analysed.
Results:
Median age of patients was 42 years (range 24-52 years) with male: female ratio of 7:2. Median duration of symptoms before presentation was 12 months (range 4-24 months). Most common symptoms were Hemoptysis (77%) and dyspnoea (66%). Fiber-optic bronchoscopy revealed endobronchial growth in all patients with six patients had growth in left main bronchus while one had growth in right main bronchus and two in right intermediate bronchus. Biopsy confirmed adenoid cystic carcinoma in 6 (66%) and muco-epidermoid carcinoma in 3 (33%) patients. Total seven patients underwent R‘0’ resection with pneumonectomy in five, bilobectomy in one, lower lobectomy in one patient. One patient developed pneumonia after left carinal pneumonectomy and succumbed to it. No major postoperative complication was encountered in remaining six patients. One patient refused surgery and one found unresectable in view of dense adhesions between lung and heart. Both patient received chemo-radiation and underwent bronchoscopic debulking and are in follow up. Median pathological tumor size was 3 cm. Median number of node harvested was 10 (range 4-18) however none showed metastasis. None of the operated patient developed relapse and overall eight patients are alive after a median follow up of 18 months.
Conclusion:
Primary salivary gland type tumors of lung (PSGTTL) are low grade malignancy and greater awareness of these tumors is necessary to avoid misdiagnosis and delay in treatment. Aggressive anatomical lung resection with preservation of functional lung parenchyma offers optimal outcome in such patients.
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P1.08-076 - Recurrence Patterns in Lung Cancer Patients Treated with Protocol Based Multimodality Treatment at a Tertiary Care Cancer Center in India (ID 4940)
14:30 - 14:30 | Author(s): A. Jakhetiya
- Abstract
Background:
Wide disparity has been reported in lung cancer survival between high income countries (HIC) and low-middle income countries (LMIC). The aim of present study is to analyze treatment outcomes and relapse patterns following protocol based multimodality management including quality control surgery in lung cancer patients from a tertiary care cancer center in India (LMIC).
Methods:
A retrospective analysis of computerized prospective clinical database of lung cancer patients treated consecutively during January 2006 to June 2015, in the department of Surgical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India was performed. The AJCC/ TNM (2010) staging system was referred for staging purpose. All patients were offered protocol based trimodality therapy (Surgery + Systemic therapy + Radiotherapy). Clinical spectrums, Follow up patterns, compliance to treatment and relapse patterns were analyzed.
Results:
A total of 136 patients underwent surgery during this period. Mean age at presentation was 53.16 years (SD 13.56) with male predominance (78%). Cough (58%) and Hemoptysis (42%) were most common presenting symptoms. Majority operated upfront (70%) and 126 (92.6%) underwent curative resection. Most common procedure was lobectomy (52%) however 42 patients (30%) underwent pneumonectomy due to advanced stage. Most common histology was squamous cell carcinoma (45%) followed by adenocarcinoma (36%). Most common stage was IIIA (30%) followed by IIB (27%). Median duration of surgery and hospital stay was 180 minutes and 7 days respectively. One patient developed post operative pneumonia and succumbed to it while 15 others developed major postoperative morbidity which was managed conservatively. Total of 30% received adjuvant chemotherapy and 11% received adjuvant radiotherapy. After median follow up of 7.26 months 16 (11.75%) patients had documented recurrences. Out of 16 patients 3 had isolated loco-regional, 4 had loco-regional with systemic and 9 had systemic recurrence. Among systemic recurrences five had multiple visceral, bone and brain in three each followed by contralateral lung in two patients.
Conclusion:
Majority of lung cancer patients presents in advanced stage. With good protocol based approach including quality-controlled surgery excellent outcomes can be achieved which are comparable to western world even in resource constrained low middle income countries like India.
