- Email: [email protected]
P4 Gastric cancer and CNS involvement registry
S10
European Journal of Cancer 50, suppl. 1 (2014) S9–S15
memorial cancer hospital from July 2006 to june 2012 were reviewed retrospectively. Patients with gastric outlet obstruction were treated by upfront surgery followed by adjuvant chemotherapy while rest were managed with perioperative chemotherapy as per the MAGIC trial protocol [3]. D1 plus nodal dissection was performed. Primary end point was overall survival after a minimum follow up of 15 months. For categorical data frequencies were calculated and means were measured for continuous variables. Chi square test was used to compare categorical data and Kaplan Meir survival analysis was performed to estimate 5-year survival outcome using SPSS. Results: Majority of the patients were male with median age of 51 years. Perioperative chemotherapy was offered to 75 patients while upfront surgery was performed in 23 patients. In perioperative chemotherapy group 51 patients and 22 in the upfront surgery group ended up having curative resection. The 5-year survival (n = 98) was found to be of 37%. The 5-year survival of patients in perioperative chemotherapy group (n = 75) was 44% while those who had a curative resection (n = 73) had a survival of 46%. Statistically significant difference was present for the actual number of observed mortalities for patients with poorly differentiated carcinoma (p = 0.005) and extranodal extension (p = 0.002). Conclusion: Gastric adenocarcinoma is an aggressive disease. Perioperative chemotherapy works well in Pakistani population as the results at our institution are comparable with international data Reference(s) [1] Kim R, Tan A, Choi, et al. Geographic differences in approach to advanced gastric cancer: Is there a standard approach. Critical Reviews in Oncology/Hematology 2013; 88: 416−26 [2] Dikshit R, Gupta P, Ramasundarahettige C, et al. Million Death Study Collaborators: Cancer mortality in India: a nationally representative survey. Lancet 2012, 379: 1807–1816. [3] Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006; 355: 11−20. Conflict of interests: No conflict of interests P4 SCIENTIFIC POSTER ABSTRACT Gastric cancer and CNS involvement registry J. Feilchenfeldt1 , Z. Varga2 , B. Schuknecht3 , M. Siano4 , S. Hofer2 . 1 Service ´ ˆ d’oncologie medicale, Hopital de Sion, Sion, Switzerland, 2 Institute of Surgical Pathology and Department of Oncology, University Hospital Zurich, Zurich, Switzerland, 3 Neuroradiology, MRI Medizinisch Radiologisches Institut, 8001, Zurich, Switzerland, 4 Department of Oncology and Hematology, Cantonal Hospital, St. Gallen, St. Gallen Switzerland Goal: In upper gastrointestinal cancer (UGI), dissemination to the central nervous system (CNS) is extremely rare. There is a need for further in-depth analysis of the pathological and clinical parameters of this patient subset. The main question of the presented registry is to study prognostic markers such as HER-2, E-Cadherin and Microsatellite Instability (MSI) in patients with gastric or distal esophageal adenocarcinoma and metastases to the brain and/or to the leptomeninges. Material and Methods: In a retrospective manner index cases were extracted from the database at the University Hospital Zurich and collaborating centers in Switzerland, Great Britain, the Netherlands and Japan. Tissue and neuroradiology were centrally analyzed where available, and only patients with a complete data set (clinical data, tissue and confirmation of CNS involvement) were included in the registry. In a prospective part patients are registered from all collaborating centers and tissue and neuroradiology are centrally analyzed. Patients have to give informed consent to be included. Analysis of HER-2, MSH2, MLH1 as well as E-Cadherin are centrally performed according to standard procedures at the Institute of Clinical Pathology, University Hospital Zurich, which includes HER2 status determined by double testing using immunohistochemistry (IHC) and silver enhanced in situ hybridization (SISH). E-Cadherin and MSI proteins are assessed immunohistochemically. Neuroimaging is centrally reviewed to confirm diagnosis of CNS involvement, alternatively a positive histology/cytology from the CNS are requested for study inclusion. All collaborating centers are listed on our site: www.gastriccancerregistry.org The study is registered on www.ClinicalTrials.gov, NCT01456455. Results: So far we collected clinical data, neuroradiological images and tumor tissue from 147 cases with primary UGI cancer and reported CNS involvement from 10 centers in Switzerland, Great Britain, the Netherlands and Japan. From 103 cases paraffin embedded tumor tissue from the primary tumor and/or the CNS metastases are available and analysed at the time of this report. On these 103 cases, two had to be excluded from the final analysis due to lack of confirmation of CNS involvement. HER2-positivity was detected in one third of all patients with CNS involvement. Neither HER2, nor E-Cadherin and MSI did have a prognostic impact on patients outcome in our series.
Non-invited Publications
Clinical and pathological results will be presented in detail at the conference. Conclusions: The prevalence HER2 positivity in our series of patients with CNS involvement is higher than expected from patients with UGI Cancer in general. Our results may have an impact on patient management in the era of anti-HER2-targeted therapies. Conflict of interests: No conflict of interests P5 SCIENTIFIC POSTER ABSTRACT Stomach cancer in Niamey: first results from the Niger Cancer Registry S. Mamoudou Garba1,2 , H. Hami1 , H. Mahamadou Zaki2 , A. Soulaymani1 , H. Nouhou2 , A. Quyou1 . 1 Laboratory of Genetics and Biometry, Faculty of Science, Ibn Tofa¨ıl University, Kenitra, Morocco, 2 Laboratory of Pathological Anatomy and Cytology, Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger Goals: Stomach cancer is a relatively uncommon cancer. In western Africa, it is the seventh most common cancer and the seventh most common cause of cancer death in both men and women, with about 5 204 new cases of stomach cancer and 4 932 cancer deaths in 2012 (GLOBOCAN 2012). The aim of this study is to determine the epidemiological profile of stomach cancer in Niamey, Niger’s capital. Methods: This is a retrospective study of stomach cancer cases, reported between 1992 and 2009 to the Niger Cancer Registry, established in 1992, in the Faculty of Health Sciences at the Abdou Moumouni University in Niamey. Results: A total of 127 cases were diagnosed with stomach cancer in Niamey, which was 2.6% of all cancers reported during the study period. More than half of the cases (56.7%) were men with a male-female ratio of 1.31. In 1992–2009, stomach cancer was the 14th most common cancer and the seventh leading cause of cancer death in both men and women in Niamey. The average age at diagnosis of stomach cancer was 47.3±16.3 years. More than three-quarters (78.7%) of people diagnosed with the disease were older than 35 years, with 67.7% of new cancer cases and 72.7% of cancer deaths occurring among those aged 35−64 years. Most stomach cancers were adenocarcinomas. The risk of developing stomach cancer varied among various ethnic groups. Djerma-Sonrai was more likely to develop stomach cancer than any other ethnic groups. Among all diagnosed cases, 17.3% died during the study period, accounting for 3.4% of all cancer deaths. Conclusion: Stomach cancer remains an important public health issue. Early diagnosis is difficult because the disease is asymptomatic in its early stages. Conflict of interests: No conflict of interests
Oesophageal Cancer P6 SCIENTIFIC POSTER ABSTRACT Comparison of outcomes following minimally invasive versus transhiatal esophagectomy for esophageal cancer; a case control study F. Rizvi1 , A.A. Syed1 , S. Khattak1 , A.R. Khan1 , W. Zia1 . 1 Department of Surgical Oncology, Shaukat Khanum Memorial Cancer and Research Centre, Lahore, Pakistan Introduction: Esophageal cancer is the seventh leading cause of cancer related death. Esophageal resection provides best survival advantage. Two common procedures are Ivor lewis esophagectomy and transhiatal esophagectomy. Both procedures have high morbidity rates of 20−46%. Minimally invasive esophagectomy has been introduced to decrease morbidity [1−5]. So we performed a case control study to compare the outcomes of minimally invasive (MIE) with transhiatal esophagectomy (TH). Materials and Methods: All patients undergoing MIE and TH esophagectomy at our institute for resectable esophageal cancers between January 2011 till May 2013 were prospectively reviewed. Record was kept for any intraoperative as well as postoperative morbidity and mortality. All patients were followed for minimum of six months Patients were well matched for age, gender and stage distribution in both groups. We compared the descriptive statistics using 2 x 2 table and chi square test was applied for significance, for continuous variables, means were calculated for both procedures and compared using one sample t test. Analysis was done using spss 19. Results: During this period we performed 65 esophagectomies; 26/65 transhiatal while 39/65 minimally invasive esophagectomies. All patients had R0 resection. Overall perioperative morbidity was 26%, 13 (33.33%) patients in MIE group while 4 (15.38%) patients in TH group encountered some intraoperative or postoperative complication. Wound infection occurred in 3 (7.69%) patients undergoing MIE while 1 (3.64%) patient undergoing TH suffered from this morbidity. There were 4 anastomotic leaks with 2 involving both groups. We encountered 4 respiratory complications all of these occurred in MIE group. Mean operative time for transhiatal group was 245 minutes compared to 373 minutes for MIE group, independent sample t test showed p value of 0.030. Mean ICU stay was also longer for MIE group, 3 days compared to 1 day for TH group. Mean stay in hospital for TH group was
European Journal of Cancer 50, suppl. 1 (2014) S9–S15
memorial cancer hospital from July 2006 to june 2012 were reviewed retrospectively. Patients with gastric outlet obstruction were treated by upfront surgery followed by adjuvant chemotherapy while rest were managed with perioperative chemotherapy as per the MAGIC trial protocol [3]. D1 plus nodal dissection was performed. Primary end point was overall survival after a minimum follow up of 15 months. For categorical data frequencies were calculated and means were measured for continuous variables. Chi square test was used to compare categorical data and Kaplan Meir survival analysis was performed to estimate 5-year survival outcome using SPSS. Results: Majority of the patients were male with median age of 51 years. Perioperative chemotherapy was offered to 75 patients while upfront surgery was performed in 23 patients. In perioperative chemotherapy group 51 patients and 22 in the upfront surgery group ended up having curative resection. The 5-year survival (n = 98) was found to be of 37%. The 5-year survival of patients in perioperative chemotherapy group (n = 75) was 44% while those who had a curative resection (n = 73) had a survival of 46%. Statistically significant difference was present for the actual number of observed mortalities for patients with poorly differentiated carcinoma (p = 0.005) and extranodal extension (p = 0.002). Conclusion: Gastric adenocarcinoma is an aggressive disease. Perioperative chemotherapy works well in Pakistani population as the results at our institution are comparable with international data Reference(s) [1] Kim R, Tan A, Choi, et al. Geographic differences in approach to advanced gastric cancer: Is there a standard approach. Critical Reviews in Oncology/Hematology 2013; 88: 416−26 [2] Dikshit R, Gupta P, Ramasundarahettige C, et al. Million Death Study Collaborators: Cancer mortality in India: a nationally representative survey. Lancet 2012, 379: 1807–1816. [3] Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006; 355: 11−20. Conflict of interests: No conflict of interests P4 SCIENTIFIC POSTER ABSTRACT Gastric cancer and CNS involvement registry J. Feilchenfeldt1 , Z. Varga2 , B. Schuknecht3 , M. Siano4 , S. Hofer2 . 1 Service ´ ˆ d’oncologie medicale, Hopital de Sion, Sion, Switzerland, 2 Institute of Surgical Pathology and Department of Oncology, University Hospital Zurich, Zurich, Switzerland, 3 Neuroradiology, MRI Medizinisch Radiologisches Institut, 8001, Zurich, Switzerland, 4 Department of Oncology and Hematology, Cantonal Hospital, St. Gallen, St. Gallen Switzerland Goal: In upper gastrointestinal cancer (UGI), dissemination to the central nervous system (CNS) is extremely rare. There is a need for further in-depth analysis of the pathological and clinical parameters of this patient subset. The main question of the presented registry is to study prognostic markers such as HER-2, E-Cadherin and Microsatellite Instability (MSI) in patients with gastric or distal esophageal adenocarcinoma and metastases to the brain and/or to the leptomeninges. Material and Methods: In a retrospective manner index cases were extracted from the database at the University Hospital Zurich and collaborating centers in Switzerland, Great Britain, the Netherlands and Japan. Tissue and neuroradiology were centrally analyzed where available, and only patients with a complete data set (clinical data, tissue and confirmation of CNS involvement) were included in the registry. In a prospective part patients are registered from all collaborating centers and tissue and neuroradiology are centrally analyzed. Patients have to give informed consent to be included. Analysis of HER-2, MSH2, MLH1 as well as E-Cadherin are centrally performed according to standard procedures at the Institute of Clinical Pathology, University Hospital Zurich, which includes HER2 status determined by double testing using immunohistochemistry (IHC) and silver enhanced in situ hybridization (SISH). E-Cadherin and MSI proteins are assessed immunohistochemically. Neuroimaging is centrally reviewed to confirm diagnosis of CNS involvement, alternatively a positive histology/cytology from the CNS are requested for study inclusion. All collaborating centers are listed on our site: www.gastriccancerregistry.org The study is registered on www.ClinicalTrials.gov, NCT01456455. Results: So far we collected clinical data, neuroradiological images and tumor tissue from 147 cases with primary UGI cancer and reported CNS involvement from 10 centers in Switzerland, Great Britain, the Netherlands and Japan. From 103 cases paraffin embedded tumor tissue from the primary tumor and/or the CNS metastases are available and analysed at the time of this report. On these 103 cases, two had to be excluded from the final analysis due to lack of confirmation of CNS involvement. HER2-positivity was detected in one third of all patients with CNS involvement. Neither HER2, nor E-Cadherin and MSI did have a prognostic impact on patients outcome in our series.
Non-invited Publications
Clinical and pathological results will be presented in detail at the conference. Conclusions: The prevalence HER2 positivity in our series of patients with CNS involvement is higher than expected from patients with UGI Cancer in general. Our results may have an impact on patient management in the era of anti-HER2-targeted therapies. Conflict of interests: No conflict of interests P5 SCIENTIFIC POSTER ABSTRACT Stomach cancer in Niamey: first results from the Niger Cancer Registry S. Mamoudou Garba1,2 , H. Hami1 , H. Mahamadou Zaki2 , A. Soulaymani1 , H. Nouhou2 , A. Quyou1 . 1 Laboratory of Genetics and Biometry, Faculty of Science, Ibn Tofa¨ıl University, Kenitra, Morocco, 2 Laboratory of Pathological Anatomy and Cytology, Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger Goals: Stomach cancer is a relatively uncommon cancer. In western Africa, it is the seventh most common cancer and the seventh most common cause of cancer death in both men and women, with about 5 204 new cases of stomach cancer and 4 932 cancer deaths in 2012 (GLOBOCAN 2012). The aim of this study is to determine the epidemiological profile of stomach cancer in Niamey, Niger’s capital. Methods: This is a retrospective study of stomach cancer cases, reported between 1992 and 2009 to the Niger Cancer Registry, established in 1992, in the Faculty of Health Sciences at the Abdou Moumouni University in Niamey. Results: A total of 127 cases were diagnosed with stomach cancer in Niamey, which was 2.6% of all cancers reported during the study period. More than half of the cases (56.7%) were men with a male-female ratio of 1.31. In 1992–2009, stomach cancer was the 14th most common cancer and the seventh leading cause of cancer death in both men and women in Niamey. The average age at diagnosis of stomach cancer was 47.3±16.3 years. More than three-quarters (78.7%) of people diagnosed with the disease were older than 35 years, with 67.7% of new cancer cases and 72.7% of cancer deaths occurring among those aged 35−64 years. Most stomach cancers were adenocarcinomas. The risk of developing stomach cancer varied among various ethnic groups. Djerma-Sonrai was more likely to develop stomach cancer than any other ethnic groups. Among all diagnosed cases, 17.3% died during the study period, accounting for 3.4% of all cancer deaths. Conclusion: Stomach cancer remains an important public health issue. Early diagnosis is difficult because the disease is asymptomatic in its early stages. Conflict of interests: No conflict of interests
Oesophageal Cancer P6 SCIENTIFIC POSTER ABSTRACT Comparison of outcomes following minimally invasive versus transhiatal esophagectomy for esophageal cancer; a case control study F. Rizvi1 , A.A. Syed1 , S. Khattak1 , A.R. Khan1 , W. Zia1 . 1 Department of Surgical Oncology, Shaukat Khanum Memorial Cancer and Research Centre, Lahore, Pakistan Introduction: Esophageal cancer is the seventh leading cause of cancer related death. Esophageal resection provides best survival advantage. Two common procedures are Ivor lewis esophagectomy and transhiatal esophagectomy. Both procedures have high morbidity rates of 20−46%. Minimally invasive esophagectomy has been introduced to decrease morbidity [1−5]. So we performed a case control study to compare the outcomes of minimally invasive (MIE) with transhiatal esophagectomy (TH). Materials and Methods: All patients undergoing MIE and TH esophagectomy at our institute for resectable esophageal cancers between January 2011 till May 2013 were prospectively reviewed. Record was kept for any intraoperative as well as postoperative morbidity and mortality. All patients were followed for minimum of six months Patients were well matched for age, gender and stage distribution in both groups. We compared the descriptive statistics using 2 x 2 table and chi square test was applied for significance, for continuous variables, means were calculated for both procedures and compared using one sample t test. Analysis was done using spss 19. Results: During this period we performed 65 esophagectomies; 26/65 transhiatal while 39/65 minimally invasive esophagectomies. All patients had R0 resection. Overall perioperative morbidity was 26%, 13 (33.33%) patients in MIE group while 4 (15.38%) patients in TH group encountered some intraoperative or postoperative complication. Wound infection occurred in 3 (7.69%) patients undergoing MIE while 1 (3.64%) patient undergoing TH suffered from this morbidity. There were 4 anastomotic leaks with 2 involving both groups. We encountered 4 respiratory complications all of these occurred in MIE group. Mean operative time for transhiatal group was 245 minutes compared to 373 minutes for MIE group, independent sample t test showed p value of 0.030. Mean ICU stay was also longer for MIE group, 3 days compared to 1 day for TH group. Mean stay in hospital for TH group was