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P.K. Garg
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- 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): P.K. Garg
- 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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P2.04 - Poster Session with Presenters Present (ID 466)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.04-033 - Primary Salivary Gland Tumors of the Lung: A Systematic Review and Pooled Analysis (ID 5728)
14:30 - 14:30 | Author(s): P.K. Garg
- Abstract
Background:
Salivary gland type neoplasms are known to occur at multiple organ sites in view of basic structural homology among exocrine glands in these anatomic sites. Primary salivary gland type tumors of lung (PSGTTL) are rare intra-thoracic malignant neoplasm. They are believed to arise from the sub-mucosal glands of the trachea-bronchial tree. Their description in literature is largely limited to a few case series/case reports. A greater awareness of PSGTTL is essential for accurate diagnosis and proper clinical management. A systematic review and pooled analysis of previously reported cases of PSGTTL is presented here
Methods:
We searched the electronic database of Pubmed using key words ("lung neoplasm"[Mesh] AND "salivary gland tumors"[Mesh] to identify the papers documenting the PSGTTL. Filters (publication date from 1900/01/01 to 2015/12/31, Humans, and English) were applied to refine the search. All the articles which were single case reports or had exclusively presented one pathological type of PSGTTL were not included in the review. A pooled analysis of clinical, pathological, treatment and survival data was performed.
Results:
The present systematic review included 5 studies and a total of 233 patients. Mean age of the patients was 41 years (range 6-80 years) and there was a male preponderance (1.3:1). Common pathological types were mucoepidermoid (MEC) (56.6%), adenoid cystic (ACC) (39.5%), and epithelial-myoepithelial cancer (3.8%). Tumors were located in central airways (trachea and major bronchi) in 43.3% patients. Mean tumor size was 4.2 cm. Surgery was the primary treatment undertaken in 82.4% patients while radiotherapy and chemotherapy was also used in 15.9% and 9.4% patients. Lymph node involvement was seen in 15.2% patients. Disease recurrences were observed in 21.1% patients (12.9% and 37.5% in MEC and ACC respectively). 3-year, 5-year, and 10-year weighted overall survival was 86.4%, 81.4%, and 73.6% (93.8%, 90.0% and 85.0% respectively for MEC; 76.7%, 62.8% and 50.5% respectively for ACC).
Conclusion:
Surgery is the primary treatment of PSGTTL resulting in good long-term survival. ACC histological type has a poor prognosis with more disease recurrences compared to MEC. Role of chemotherapy and radiotherapy in the management of PSGTTL warrants further studies.
