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Superior Vena Cava Syndrome in Lung Cancer: Analysis of Eight Years in a Central Hospital
March 2014, Vol 145, No. 3_MeetingAbstracts Lung Cancer | March 2014
Superior Vena Cava Syndrome in Lung Cancer: Analysis of Eight Years in a Central Hospital Ines Sanches, MD; Lígia Fernandes, MD; Cláudia Lares dos Santos, MD; Ana Figueiredo, MD; Fernando Barata, MD Pulmonology Department - Centro Hospitalar e Universitário de Coimbra- Hospital Geral, Coimbra, Portugal
Chest. 2014;145(3_MeetingAbstracts):322A. doi:10.1378/chest.1826466
Abstract SESSION TITLE: Lung Cancer Posters II SESSION TYPE: Poster Presentations PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM PURPOSE: The superior vena cava syndrome (SVCS) is caused by a gradual and insidious obtruction/compression of the superior vena cava (SVC). The most frequent etiology are malignant mediastinal tumors (80%) and lung cancer account for 75-80% of all these cases, with most of these being small-cell carcinomas. SVCS treatment depends on etiology. Aims: Characterization of lung carcinoma patients who developed SVCS and its subsequent treatment. METHODS: Retrospective analysis of patients with lung cancer, admitted in a pulmonology department with SVCS, between 2004 a 2011. RESULTS: 35 patients included, of which 85.7% male, aged 60.5±10.1 years; 54.3% of patients showed SVCS as an initial expression of lung cancer. Histological tumor confirmation was obtained by broncofibroscopy (65.7%), transthoracic biopsy (17.1%), videothoracoscopy (8.6%), mediastinoscopy (5.7%) and by peripheral ganglion excision (2.9%). The most frequents histological type were adenocarcinoma (40%), small cell lung carcinoma (31.3%) and squamous cell carcinoma (25.7%). Majority of patients presented a IV stage (62.9%), with more frequent metastization in lung and bone; performance status was 0-1 in 59.0% of cases, 2 in 28.6% and 3 in
11.4%. A thoracic CT scan confirmed SVC compression in 51.4% of cases, invasion in 22.9% and obstruction in 25.7%. Of 35 total patients, 3 died in the initial treatment and 2 died in 30 days, all without specific treatment. Of the 30 remaining patients, 66.7% started urgent radiotherapy and in 33.3% a stent was placed in the SVC. All patients presented symptomatic resolution of the SVCS with specific therapy, but 6.7% of then shown SVCS reappearing and therefore started urgent radiotherapy and stent was replaced. CONCLUSIONS: SVCS can be an initial manifestation of lung cancer. A quick diagnosis and start treatment are essencial to a success local control of this oncologic emergency. CLINICAL IMPLICATIONS: A quick diagnosis and start treatment of SVCS are essencial to a successful local control of this oncologic emergency. DISCLOSURE: The following authors have nothing to disclose: Ines Sanches, Lígia Fernandes, Cláudia Lares dos Santos, Ana Figueiredo, Fernando Barata No Product/Research Disclosure Information
Superior Vena Cava Syndrome in Lung Cancer: Analysis of Eight Years in a Central Hospital Ines Sanches, MD; Lígia Fernandes, MD; Cláudia Lares dos Santos, MD; Ana Figueiredo, MD; Fernando Barata, MD Pulmonology Department - Centro Hospitalar e Universitário de Coimbra- Hospital Geral, Coimbra, Portugal
Chest. 2014;145(3_MeetingAbstracts):322A. doi:10.1378/chest.1826466
Abstract SESSION TITLE: Lung Cancer Posters II SESSION TYPE: Poster Presentations PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM PURPOSE: The superior vena cava syndrome (SVCS) is caused by a gradual and insidious obtruction/compression of the superior vena cava (SVC). The most frequent etiology are malignant mediastinal tumors (80%) and lung cancer account for 75-80% of all these cases, with most of these being small-cell carcinomas. SVCS treatment depends on etiology. Aims: Characterization of lung carcinoma patients who developed SVCS and its subsequent treatment. METHODS: Retrospective analysis of patients with lung cancer, admitted in a pulmonology department with SVCS, between 2004 a 2011. RESULTS: 35 patients included, of which 85.7% male, aged 60.5±10.1 years; 54.3% of patients showed SVCS as an initial expression of lung cancer. Histological tumor confirmation was obtained by broncofibroscopy (65.7%), transthoracic biopsy (17.1%), videothoracoscopy (8.6%), mediastinoscopy (5.7%) and by peripheral ganglion excision (2.9%). The most frequents histological type were adenocarcinoma (40%), small cell lung carcinoma (31.3%) and squamous cell carcinoma (25.7%). Majority of patients presented a IV stage (62.9%), with more frequent metastization in lung and bone; performance status was 0-1 in 59.0% of cases, 2 in 28.6% and 3 in
11.4%. A thoracic CT scan confirmed SVC compression in 51.4% of cases, invasion in 22.9% and obstruction in 25.7%. Of 35 total patients, 3 died in the initial treatment and 2 died in 30 days, all without specific treatment. Of the 30 remaining patients, 66.7% started urgent radiotherapy and in 33.3% a stent was placed in the SVC. All patients presented symptomatic resolution of the SVCS with specific therapy, but 6.7% of then shown SVCS reappearing and therefore started urgent radiotherapy and stent was replaced. CONCLUSIONS: SVCS can be an initial manifestation of lung cancer. A quick diagnosis and start treatment are essencial to a success local control of this oncologic emergency. CLINICAL IMPLICATIONS: A quick diagnosis and start treatment of SVCS are essencial to a successful local control of this oncologic emergency. DISCLOSURE: The following authors have nothing to disclose: Ines Sanches, Lígia Fernandes, Cláudia Lares dos Santos, Ana Figueiredo, Fernando Barata No Product/Research Disclosure Information