2285 Optimal chemotherapy schemes in treatment of unresectable pancreatic cancer

Abstracts 2283 POSTER Resection of liver metastasis in patients with gastrointestinal stromal tumors in the imatinib era: A nationwide retrospective study R. Tielen1 , M. Seesing2 , R. Van Hillegersberg2 , C. Verhoef3 , F. Van Coevorden4 , K. De Jong5 , I. Nagtegaal6 , J. De Wilt1 . 1 Radboud University Nijmegen Medical Centre, Surgery, Nijmegen, Netherlands; 2 UMC Utrecht, Surgery, Utrecht, Netherlands; 3 Erasmus Medical Centre, Surgery, Rotterdam, Netherlands; 4 Netherlands Cancer Institute, Surgery, Amsterdam, Netherlands; 5 UMC Groningen, Surgery, Groningen, Netherlands; 6 Radboud University Nijmegen Medical Centre, Pathology, Nijmegen, Netherlands Background: The aims of this retrospective study were to study the effectiveness and safety of resection of liver metastases from gastrointestinal stromal tumors in the imatinib era and to identify prognostic factors for overall survival. Material and Methods: All patients who underwent resection of liver metastases from GIST in the Netherlands since 1999 were included using the national registry of histo- and cytopathology (PALGA). Study data were retrospectively collected from patient files in various hospitals. Kaplan Meier survival analysis was used for calculating survival outcome. Univariate and multivariate regression analyses were carried out for the assessment of potential prognostic factors. Results: Fifty patients (31 male, 19 female) were identified, in 24 patients (48%) the primary tumor was located in the stomach. Median age at liver resection was 59 (range 35−81) years.Thirty-five patients (70%) underwent a resection of the primary tumor before liver resection and in 12 patients (24%) the primary tumor was removed simultaneously. Thirty patients (60%) received tyrosine kinase inhibitor therapy before liver surgery, and 36 patients (72%) postoperatively. A minor and major liver resection was performed in 32 and 16 patients, respectively without postoperative mortality. A complete (R0) and incomplete (R1/R2) resection was performed in 27 (54%) and 23 (46%) patients, respectively. Median follow-up was 27 (range 1–146) months from surgery. Median progressionfree survival (PFS) was 66 (range 40−92) months. One-, three-, and fiveyear PFS was 93%, 67%, and 59% respectively. Median overall survival (OS) was 90 (range 61–141) months from surgery. The one-, three-, and five-year OS was 93%, 80%, and 76% respectively. A R0 resection was the only independent significant prognostic factor for DFS and OS at multivariate analysis (p = 0.02). Conclusion: Resection of liver metastases in a selected group of GIST patients is safe and may be associated with prolonged overall survival when a complete resection can be achieved. No conflict of interest. 2284 POSTER Other primary malignancies in patients with esophageal cancer: Prevalence and its influence on survival T. Tanaka1 , S. Matono1 , N. Mori1 , H. Hino1 , K. Kadoya1 , R. Nishida1 , Y. Akagi1 , H. Fujita2 . 1 Kurume University School of Medicine, Surgery, Kurume, Japan; 2 Fukuoka Wajiro Hospital, Surgery, Fukuoka, Japan Background: Esophageal cancer patients are known to have an increased risk of other primary malignancies (OPMs), and these patients have generally been thought to carry a dismal prognosis. The purpose of this study was to examine the incidence of OPMs and to evaluate its influence on survival in patients with esophageal cancer. Material and Methods: A prospectively maintained database identified 331 patients who had R0 esophagectomy for T1−3 esophageal cancer (307 squamous cell crcinoma; 92.7%, 24 adenocarcinoma; 7.3%) in Kurume University Hospital between January 2000 and August 2013. Incidence and the prognostic influence of OPMs in these patients were investigated. OPMs were defined as antecedent (1 year before diagnosis of esophageal cancer), synchronous (within 1 year of diagnosis of esophageal cancer), and subsequent (1 year after diagnosis of esophageal cancer). Median follow-up was 79 months. Results: Of 331 patients, 109 patients had pT1 tumor, 54 had pT2 tumor, and 168 had pT3 tumor. The numbers of patients at Stage IA/IB/IIA/IIB/IIIA/IIIB/IIIC/IV were 79/22/42/33/56/41/30/27. 118 patients (35.7%) had OPMs. The incidence of OPMs in patients with esophageal squamous cell carcinoma was 37.5% compared with 12.5% for the adenocarcinoma patients (P = 0.0139). There was no difference in the incidence of OPMs among patients with T1, T2, and T3 tumor (T1, 33.9%; T2, 38.9%; T3, 35.7%; P = 0.8247). Of these, 56 had synchronous cancer, 37 had antecedent cancer, and 43 had subsequent cancer. Fourteen of the 89 patients with antecedent and/or synchronous cancers had subsequent cancers. The most frequent affected organs were head and neck (49 patients), followed by stomach (33 patients), and colon-rectum (18 patients). Twenty-four patients had OPMs in two or more organs. The

S427 overall 5-year survival rate for the whole group was 60.3%. The 5-year survival rate was 56.6% for patients with OPMs, and 62.7% for patients without OPMs. There was no difference in survival between two groups (P = 0.1779). Death occurred in 146 patients (44.1%): 83 (56.9%) died of esophageal cancer, 38 (26%) died of noncancer-related causes, and 25 (17.1%) died of OPM. Within three years of surgery, major cause of death was a recurrence of esophageal cancer (70.5%); thereafter OPM (39.2%) and recurrence (31.4%) were two major causes of death. Conclusions: Esophageal cancer was highly associated with other primary malignancy. However, there was no significant difference in survival after R0 resection for esophageal cancer between patients with and without other primary malignancy. Close follow-up after surgery for esophageal cancer and rigorous screening for early detection of other primary malignancy might lead to similar survival rates between patients with other primary cancer and patients without. No conflict of interest. 2285 POSTER Optimal chemotherapy schemes in treatment of unresectable pancreatic cancer F. Djuraev1 . 1 Tashkent Medical Academy, oncology, Tashkent, Uzbekistan Background: To improve the results of treatment of unresectable pancreatic cancer by optimizing chemotherapy regimens. Materials and Methods: The study is based on the results of treatment of 43 patients with unresectable pancreatic cancer who were treated at the Tashkent City Oncology Center. Males 28 (65.2%), females 15 (34.8%). Age ranged from 42 to 76 years. Diagnoses were established on the basis of modern standard methods of investigations, all patients had T4N1M0. Diagnoses were verified histologically in all. From them in 26 cases verification of the diagnosis was achieved by means of percutaneous transgastric biopsy of the tumor in 17 cases diagnoses were verified during draining surgery for obstructive jaundice and duodenostenosis. According to the verification: adenocarcinoma was diagnosed in 31 patients, acinar carcinoma in 6, undifferentiated carcinoma in 4 patients and carcinoid in 2 patients. Depending on the regimens of chemotherapy, patients were divided into 2 groups. According to main prognostic factors, both groups were identical. 1 gr. n = 22 patients, GF scheme, Gemcitabine − 1000 mg/m2 on 1,8,15 day and Fluorouracil bolus − 400 mg/m2 on 1 and 4 th day. 2 gr. n = 21 patients, DC scheme, Docetaxel − 35mg/m2 , and Gemcitabine 1000 mg/m2 , octreotide − 200mkg. All drugs used in combination on 1.8 and 15-th day. The course of treatment was repeated every 4 weeks. In both groups, were held on 6 courses of polychemotherapy. Results: In the first group pain fully disappeared in 3 (13.6%) patients, decreased partially in 13 (59.1%) patients, and no effect was observed in 6 (27.3%) patients. In the second group, pain completely disappeared in 5 (23.8%) patients, decreased in 14 (66.6%) cases and no effect in 2 (9.5%) patients. Improvement of patients’ general condition was observed in 1st group in 14 (63.6%) patients and in 2nd group in 19 (90.4%) patients.. In the first group, the objective effect was observed in 43.4% of patients, the median of survival was equal to 0.3 months. In the 2 nd group objective effect was observed in 64.5% of patients, the median survival was 12.2 months. Conclusion: Studies in the two groups showed, that the results of the use of DC schemes in combination with octreotide in cases of unresectable pancreatic cancer was significantly better than the scheme of GF. The relatively high efficiency DC with octreotide may be an indirect sign of proving the existence of hormone-dependant forms of pancreatic tumors. No conflict of interest. 2286 POSTER Experience of surgical treatment of pariampullary zone tumors M. Djuraev1 , S. Navruzov2 , D. Egamberdiev1 . 1 National Cancer Research Center of Uzbekistan, Abdominal Oncology, Tashkent, Uzbekistan; 2 National Cancer Research Center of Uzbekistan, Coloproctology, Tashkent, Uzbekistan Background: To improve the results of surgical treatment for periampullary zone tumors Materials and Methods: During the period of 2008–2014 at the abdominal surgery department of National Cancer Research Center 38 patients with tumors of periampullary zone underwent gastropancreatoduodenal resection. Of them in 24 patients were found cancer of the pancreatic head, in 10 cases was found cancer of Vater papilla, and 3 patients had cancer of duodenum. Histological verification before operation was successful in 29 (76.3%) patients. Tumors with diameter up to 4 cm in greatest dimension were found in 8 patients, up to 5 cm in 20 patients, bigger than 5 cm in 10 patients. 22 patients at the time of admission to hospital had signs