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CLC055 POSTER Electrocautery is an alternative therapy for treatment of selected endobronchial tumors
S14
Abstracts of the 5th International Congress on Lung Cancer, Patras, Greece, 24–27 January 2007
CLC055
POSTER
Electrocautery is an alternative therapy for treatment of selected endobronchial tumors
Sakellaridis T., Konstantinou M., Koulaxouzidis G., Panagiotou I., Papamichalis G., Chamalakis G., Antypas G. ‘Sotiria’ General Hospital of Chest Diseases, Athens, Greece
Electrocautery is a safe procedure and is routinely used in surgery to burn unwanted or harmful tissue. It is also used to reduce or stop hemorrhaging by electrocautery and argon plasma coagulation may represent an alternative therapy for resection of selected benign endobronchial tumors ‘burning’ the bleeding blood vessels, which seals them off. The advantages of electrocautery include less expensive equipment (compared with lasers) and the ease of use through flexible or rigid bronchoscopes. The efficiency of this technique for destructing intraluminal tumours is well documented and makes it an attractive alternative to Yttrium aluminium garnet (YAG) laser photo-coagulation. Early effects of electrocautery included coagulation necrosis of the mucosa only and intense acute inflammation extending deep into the bronchial structure. The inflammatory phase may progressively resolved while extensive transmural fibrosis and deterioration of the cartilage plates developed. The nature and extent of these lesions did not depend upon the energy delivered (40 W versus 120 W). We can refer our experience of three patients, two with NSLC and one with SCLC who have severe bronchial obstructions, dyspnea and respiratory insufficient. Two of theme took chemotherapy and on theme was treated with radiotherapy. We use monopolar electrocautery to treat theme before they start their therapy per alleviate the symptoms and give the time to treatment to work. The results were spectacular. All of theme had grate relief of the symptoms and they could conclude their therapy successfully. We follow up these patients for two years and they don’t have any complication due to the electrocautery. In conclusion bronchoscopic electrocautery is equally effective but is a less expensive and, in our hospital, a more accessible modality than the Nd-YAG laser for symptomatic palliation of patients with intraluminal airway obstruction.
POSTER
Correlation of tumor markers between serum and pleural fluid Trakas N., Sklapani P., Briola E., Gambroudi M., Papadopoulou A., Lekkakou A. Sismanoglio General Hospital, Greece Malignant tumor take the second place after cardiovascular diseases, in the mortality of the population. Tumor markers offer a putative clinical use in cancer diagnosis. Pleural effusion also is a common diagnostic problem. The analysis of serum and pleural fluid for tumor markers is widely used as a diagnostic aid in clinical practice. The aim of this study was to evaluate the relationship between serum and pleural fluid using a panel of tumor markers (CEA, AFP, CA19-9, CA15-3, CA125). The study included 48 patients (28 males, 20 females), mean aged 74,7. The samples were collected from patients at the 1st Department of Respiratory Medicine. Levels of tumor markers (serum and pleural fluid) were determined using a two-site immunoluminometric assay method on Liaison analyzer (Byk-Sangtec Diagnostics). Statistical analysis was performed using the SPSS 10,0. Data are presented at Table 1. Table 1. Correlation of tumor markers between serum and pleural fluid Tumor marker CEA AFP CA-125 CA 19-9 CA 15-3
Group
Serum
Pleural fluid
positive negative positive negative positive negative positive negative positive negative
4,3% 95,7% 0 100% 87,0% 13,0% 8,3% 91,7% 40,9% 59,1%
12,5% 87,5% 0 100% 100% 0 4,2% 95,8% 28,6% 71,4%
ORAL
Bronchoplastic procedures for lung cancer
Chandrinos V., Lekkakou A., Trakas N., Lasdas L., Dritsas J. Sismanoglio General Hospital, Greece
CLC056
CLC057
Bronchoplastic techniques involve sleeve lobectomy and sleeve pneumonectomy. They consist an alternative parenchymal procedure for lung resection particularly valuable in patients with cardiac or pulmonary contraindications to pneumonectomy. The purpose of our paper is to report our experience with sleeve lobectomy. During the period 2001-2002, we performed in our Department 36 sleeve lobectomies, mainly for lung cancer. There were 31 men and 5 women, with mean age 62 years (range 25-74). All of the procedures were for non-small cell lung cancer, except one case for which the lobectomy was for typical carcinoid. Major bronchial anastomotic complication occurred in one patient and required re-operation. The mortality rate was 8,33%. The postoperative outcome of the rest patients was uneventful. The survival at 3-years intervals after sleeve lobectomy is related to the stage and not to the type of procedure Sleeve lobectomy is associated with low mortality and bronchial anastomotic complication rates and achieves local tumor control. Long-term survival is excellent in patients with carcinoid tumors. In patients with non-small cell lung cancer is N2 disease and incomplete resection.
CLC058
Panagopoulos N., Koletsis E., Karakantza M., Sakellaropoulos G., Filos K., Apostolakis E., Dougenis D. University of Patras, Greece Introduction: It has been postulated that transfusions have immunosuppressive effects that promote tumor growth and metastasis. Moreover perioperative anemia is considered an independent prognostic factor on outcome in patients operated for malignancy. We evaluated the influence of blood transfusions and perioperative anemia on survival in NSCLC patients. Materials and Methods: From 1999 through 2005, 331 consecutive patients, Male/Female=295/36 (median age 65 years), underwent radical surgery for NSCLC. Patients were divided into group A (transfused, n=85) (median age 66 years) and group B (non-transfused, n=246) (median age 65 years). Exclusion criteria included history of malignancy, autoimmune diseases, and serious comorbidities. Patients were also classified according to preoperative Hb level into different groups. Our oncologic surveillance program monitored the patients. Results: The groups were similar in terms of age, gender, diagnosis, comorbidities and operations. The overall transfusion rate was 25.7%. Patients with preoperative Hb level < 12g/dl, had shorter survival compared to those with Hb level >12 g/dl, 23 and 37 months respectively (p<0.01). Postoperative hospital stay was longer in group A (p<0.01). Overall survival was significantly shorter in group A compared with group B, 18 and 39 months respectively (p<0.01). For Stage I patients, group A had shorter survival (median 23 months) compared with group B (median 56 months) (p<0.05). Among patients with Hb < 12 g/dl survival was significantly increased (p<0.05) in non-transfused (34 months) versus transfused patients (15 months). Conclusions: Perioperative anemia is correlated with worse prognosis in patients undergoing surgery for NSCLC. Additionally, blood transfusions exert deleterious effect on survival in Stage I patients.
r
r2
0,305
0,093
0,796
0,633
0,693
0,480
CLC059
0,506
0,256
Combined heart surgery and lung tumor resection
0,573
0,329
Prokakis Chr., Panagopoulos N., Koletsis E., Tselikos D., Filos K., Apostolakis E., Dougenis D. University of Patras, Greece
There’s high correlation between serum and pleural fluid in AFP and CA-125. The marker with the highest concentration was CA-125 (serum mean = 245,4 and pleural fluid mean = 1757,8). Our results demonstrated that measurement of pleural tumor markers has a limited albeit not a negligible value in the workup of Pes. The routine or indiscriminate determination of a panel of tumor markers in all pleural fluids probably is not cost-effective and cannot be recommended. Instead we advocate to obtain such a panel in patients who have clinical data suggestive of malignant PE.
ORAL
Influence of blood transfusions and perioperative anemia on long-term survival in patients operated for non-small cell lung cancer
ORAL
Background: Combined heart surgery and lung resection remains a controversial issue. This method facilitates the treatment of two major problems with one intervention reducing the hospitalization cost with acceptable outcomes. On the other hand skepticism exists related to the effects of cardiopulmonary bypass on malignancy and to a possible greater risk for perioperative bleeding. Methods: We present a retrospective study of four male patients, who underwent combined surgical treatment for heart and lung disease in a one-step procedure, from November 2004 to August 2006. Results: Two patients underwent aortic valve replacement with right upper lobectomy for lung cancer, stages IB and IIB respectively. The other two patients underwent pulmonary wedge resection (benign lesion), one combined with coronary bypass and the other one with ascending aorta replacement. In all cases pulmonary resection was performed before cardiopulmonary bypass
Abstracts of the 5th International Congress on Lung Cancer, Patras, Greece, 24–27 January 2007
CLC055
POSTER
Electrocautery is an alternative therapy for treatment of selected endobronchial tumors
Sakellaridis T., Konstantinou M., Koulaxouzidis G., Panagiotou I., Papamichalis G., Chamalakis G., Antypas G. ‘Sotiria’ General Hospital of Chest Diseases, Athens, Greece
Electrocautery is a safe procedure and is routinely used in surgery to burn unwanted or harmful tissue. It is also used to reduce or stop hemorrhaging by electrocautery and argon plasma coagulation may represent an alternative therapy for resection of selected benign endobronchial tumors ‘burning’ the bleeding blood vessels, which seals them off. The advantages of electrocautery include less expensive equipment (compared with lasers) and the ease of use through flexible or rigid bronchoscopes. The efficiency of this technique for destructing intraluminal tumours is well documented and makes it an attractive alternative to Yttrium aluminium garnet (YAG) laser photo-coagulation. Early effects of electrocautery included coagulation necrosis of the mucosa only and intense acute inflammation extending deep into the bronchial structure. The inflammatory phase may progressively resolved while extensive transmural fibrosis and deterioration of the cartilage plates developed. The nature and extent of these lesions did not depend upon the energy delivered (40 W versus 120 W). We can refer our experience of three patients, two with NSLC and one with SCLC who have severe bronchial obstructions, dyspnea and respiratory insufficient. Two of theme took chemotherapy and on theme was treated with radiotherapy. We use monopolar electrocautery to treat theme before they start their therapy per alleviate the symptoms and give the time to treatment to work. The results were spectacular. All of theme had grate relief of the symptoms and they could conclude their therapy successfully. We follow up these patients for two years and they don’t have any complication due to the electrocautery. In conclusion bronchoscopic electrocautery is equally effective but is a less expensive and, in our hospital, a more accessible modality than the Nd-YAG laser for symptomatic palliation of patients with intraluminal airway obstruction.
POSTER
Correlation of tumor markers between serum and pleural fluid Trakas N., Sklapani P., Briola E., Gambroudi M., Papadopoulou A., Lekkakou A. Sismanoglio General Hospital, Greece Malignant tumor take the second place after cardiovascular diseases, in the mortality of the population. Tumor markers offer a putative clinical use in cancer diagnosis. Pleural effusion also is a common diagnostic problem. The analysis of serum and pleural fluid for tumor markers is widely used as a diagnostic aid in clinical practice. The aim of this study was to evaluate the relationship between serum and pleural fluid using a panel of tumor markers (CEA, AFP, CA19-9, CA15-3, CA125). The study included 48 patients (28 males, 20 females), mean aged 74,7. The samples were collected from patients at the 1st Department of Respiratory Medicine. Levels of tumor markers (serum and pleural fluid) were determined using a two-site immunoluminometric assay method on Liaison analyzer (Byk-Sangtec Diagnostics). Statistical analysis was performed using the SPSS 10,0. Data are presented at Table 1. Table 1. Correlation of tumor markers between serum and pleural fluid Tumor marker CEA AFP CA-125 CA 19-9 CA 15-3
Group
Serum
Pleural fluid
positive negative positive negative positive negative positive negative positive negative
4,3% 95,7% 0 100% 87,0% 13,0% 8,3% 91,7% 40,9% 59,1%
12,5% 87,5% 0 100% 100% 0 4,2% 95,8% 28,6% 71,4%
ORAL
Bronchoplastic procedures for lung cancer
Chandrinos V., Lekkakou A., Trakas N., Lasdas L., Dritsas J. Sismanoglio General Hospital, Greece
CLC056
CLC057
Bronchoplastic techniques involve sleeve lobectomy and sleeve pneumonectomy. They consist an alternative parenchymal procedure for lung resection particularly valuable in patients with cardiac or pulmonary contraindications to pneumonectomy. The purpose of our paper is to report our experience with sleeve lobectomy. During the period 2001-2002, we performed in our Department 36 sleeve lobectomies, mainly for lung cancer. There were 31 men and 5 women, with mean age 62 years (range 25-74). All of the procedures were for non-small cell lung cancer, except one case for which the lobectomy was for typical carcinoid. Major bronchial anastomotic complication occurred in one patient and required re-operation. The mortality rate was 8,33%. The postoperative outcome of the rest patients was uneventful. The survival at 3-years intervals after sleeve lobectomy is related to the stage and not to the type of procedure Sleeve lobectomy is associated with low mortality and bronchial anastomotic complication rates and achieves local tumor control. Long-term survival is excellent in patients with carcinoid tumors. In patients with non-small cell lung cancer is N2 disease and incomplete resection.
CLC058
Panagopoulos N., Koletsis E., Karakantza M., Sakellaropoulos G., Filos K., Apostolakis E., Dougenis D. University of Patras, Greece Introduction: It has been postulated that transfusions have immunosuppressive effects that promote tumor growth and metastasis. Moreover perioperative anemia is considered an independent prognostic factor on outcome in patients operated for malignancy. We evaluated the influence of blood transfusions and perioperative anemia on survival in NSCLC patients. Materials and Methods: From 1999 through 2005, 331 consecutive patients, Male/Female=295/36 (median age 65 years), underwent radical surgery for NSCLC. Patients were divided into group A (transfused, n=85) (median age 66 years) and group B (non-transfused, n=246) (median age 65 years). Exclusion criteria included history of malignancy, autoimmune diseases, and serious comorbidities. Patients were also classified according to preoperative Hb level into different groups. Our oncologic surveillance program monitored the patients. Results: The groups were similar in terms of age, gender, diagnosis, comorbidities and operations. The overall transfusion rate was 25.7%. Patients with preoperative Hb level < 12g/dl, had shorter survival compared to those with Hb level >12 g/dl, 23 and 37 months respectively (p<0.01). Postoperative hospital stay was longer in group A (p<0.01). Overall survival was significantly shorter in group A compared with group B, 18 and 39 months respectively (p<0.01). For Stage I patients, group A had shorter survival (median 23 months) compared with group B (median 56 months) (p<0.05). Among patients with Hb < 12 g/dl survival was significantly increased (p<0.05) in non-transfused (34 months) versus transfused patients (15 months). Conclusions: Perioperative anemia is correlated with worse prognosis in patients undergoing surgery for NSCLC. Additionally, blood transfusions exert deleterious effect on survival in Stage I patients.
r
r2
0,305
0,093
0,796
0,633
0,693
0,480
CLC059
0,506
0,256
Combined heart surgery and lung tumor resection
0,573
0,329
Prokakis Chr., Panagopoulos N., Koletsis E., Tselikos D., Filos K., Apostolakis E., Dougenis D. University of Patras, Greece
There’s high correlation between serum and pleural fluid in AFP and CA-125. The marker with the highest concentration was CA-125 (serum mean = 245,4 and pleural fluid mean = 1757,8). Our results demonstrated that measurement of pleural tumor markers has a limited albeit not a negligible value in the workup of Pes. The routine or indiscriminate determination of a panel of tumor markers in all pleural fluids probably is not cost-effective and cannot be recommended. Instead we advocate to obtain such a panel in patients who have clinical data suggestive of malignant PE.
ORAL
Influence of blood transfusions and perioperative anemia on long-term survival in patients operated for non-small cell lung cancer
ORAL
Background: Combined heart surgery and lung resection remains a controversial issue. This method facilitates the treatment of two major problems with one intervention reducing the hospitalization cost with acceptable outcomes. On the other hand skepticism exists related to the effects of cardiopulmonary bypass on malignancy and to a possible greater risk for perioperative bleeding. Methods: We present a retrospective study of four male patients, who underwent combined surgical treatment for heart and lung disease in a one-step procedure, from November 2004 to August 2006. Results: Two patients underwent aortic valve replacement with right upper lobectomy for lung cancer, stages IB and IIB respectively. The other two patients underwent pulmonary wedge resection (benign lesion), one combined with coronary bypass and the other one with ascending aorta replacement. In all cases pulmonary resection was performed before cardiopulmonary bypass