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Annals of Oncology
received Adj-CHT and 16 (26%) Adj-RT. Median follow-up was 71 months (range
1-145), DFS and OS are the following:
% DFS (95% CI) % OS (95% CI)
Events 48 mo 60 o0 72 mo Events 48 mo 60 mo 72 mo
9 89 (80-97) 89 (80-97) 86 (76-96) 7 97 (92-100) 95 (88-100) 92 (85-100)
mo, months.
Conclusions: TETs are rare and indolent tumors. Surgery offers good results which
can be further improved by Adj such as CHT and/or RT. Supported by GIPO.
Disclosure: All authors have declared no conflicts of interest.
1537P PROGNOSTIC FACTOR FOR SURVIVAL IN PATIENTS WITH
ADVANCED THYMIC CARCINOMA
Y. Okuma 1 , Y. Hosomi 1 , Y. Nakahara 1 , M. Yomoda 1 , Y. Takagi 2 , M. Iguchi 1 ,
M. Shibuya 1 , T. Okamura 1
1 Department of Thoracic Oncology and Respiratory Medicine, Tokyo
Metropolitan Cancer and Infectious Diseases, Tokyo, JAPAN, 2 Department of
Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and
Infectious Diseases Center Komagome Hospital, Tokyo, JAPAN
Background: Thymic carcinoma is a rare cancer that represents an incidence of 0.15
per 100,000 persons per year. Thus, clinical characteristics and prognostic factors
have not been investigated in detail. In this study, we tried to elucidate the disease
profiles, outcomes, and prognostic factors for survival among patients with advanced
thymic carcinoma treated with palliative-intent chemotherapy.
Patients and methods: This study was a retrospective review of medical records of
38 patients treated with palliative-intent chemotherapy for advanced thymic
carcinoma between 1991 and 2011. Clinical demographics, histology, overall survival,
and factors expected to predict survival were analyzed. Differences in survival were
assessed using Kaplan-Meier analysis and uni- and multivariate Cox proportional
hazards regression analyses.
Results: The study included 20 males (52.6%) and 18 females (47.4%). The median
age at diagnosis was 59.5 years. The most common metastatic sites at diagnosis were
lung (44.7%), liver (15.8%), lymph nodes (15.8%), bone (13.2%), and brain (5.7%).
The most common histological subtypes were squamous cell carcinoma (73.7%),
followed by neuroendocrine carcinoma (15.8%), and mucoepidermoid carcinoma
(7.9%). The median survival time was 25.4 months. Overall survival rates at 1- and
2-years were 73.6% and 52.6%, respectively. In univariate and multivariate analyses,
the only favorable prognostic factor for overall survival was response to first-line
chemotherapy (p = 0.009).
Conclusion: Response to first-line chemotherapy may be a prognostic factor for
overall survival in patients with advanced thymic carcinoma.
Disclosure: All authors have declared no conflicts of interest.
1538P ACUTE EXACERBATION OF PRE-EXISTING INTERSTITIAL
LUNG DISEASE (ILD) IN PATIENTS (PTS) WITH LUNG
CANCER UNDER VARIOUS TREATMENTS
H. Asahina1 , S. Oizumi1 , Y. Fujita2 , K. Takamura3 , T. Kojima4 , T. Harada5 ,
Y. Kawai6 , H. Dosaka-Akita7 , H. Isobe4 , M. Nishimura1 1
First Department of Medicine, Hokkaido University School of Medicine,
Sapporo, JAPAN, 2 Department of Respiratory Medicine, National Hospital
Organization Asahikawa Medical Center, Asahikawa, JAPAN, 3 First Department
of Medicine, Hokkaido P.W.F.A.C Obihiro-Kosei General Hospital, Obihiro,
JAPAN, 4 Department of Medical Oncology and Respiratory Medicine, KKR
Sapporo Medical Center, Sapporo, JAPAN, 5 Center for Respiratory
Disease, Hokkaido Social Insurance Hospital, Sapporo, JAPAN,
6
Department of Respiratory Medicine, Oji General Hospital, Tomakomai, JAPAN,
7
Department of Medical Oncology, Hokkaido University School of Medicine,
Sapporo, JAPAN
Background: Acute deterioration of ILD for unknown causes, sometimes called as
acute exacerbation (AE), can occur at any point in the course of ILD. However, little
is known about its incidence and prognostic significance in lung cancer pts with
pre-existing ILD, who receive various treatments; chemotherapy, surgery, palliative
radiotherapy, and best supportive care (BSC).
Methods: A total of 242 subjects (6.9% of all) were retrospectively identified to have
pre-existing ILD by computed tomography (CT) from a sum of 3524 pts who had
been hospitalized for lung cancer treatment at 8 institutions during 2004 to 2009. CT
images of all the eligible pts were centrally reviewed. Univariate and multivariate
analyses were performed using a Cox proportional hazard model to examine the
potential role of any prognostic factors for overall survival (OS) from the initial lung
cancer diagnosis.
Results: Pts’ characteristics were: male/female = 217/25; median age (range) = 73
(42-98) yrs.; smoking status: ever/never = 223/19; Performance Status: 0/1/2/3/4 = 74/
121/23/19/5; Stage I/II/III/IV = 48/10/98/86; Histology: adeno/squamous/large/NOS/
small = 90/75/6/19/52; CT pattern: usual interstitial pneumonia (UIP)/non-UIP =
118/124; extent of normal lung on baseline CT: 10-50%/60-90% = 154/88;
pre-existing emphysema: yes/no = 178/64. AE occurred in 71 of 242 pts (29%)
overall; 56 of 147 pts (38%) with chemotherapy, 6 of 38 pts (16%) with surgery, 2 of
17 pts (12%) with palliative radiotherapy, and 5 of 36 pts (14%) with BSC alone, and
chemotherapy was an independent risk factor for the occurrence of AE (P < 0.001).
When separated by histology, in NSCLC, multivariate analysis revealed that age (≥70
yrs., hazard ratio [HR]: 1.84, 95%CI: 1.25-2.71, p = 0.002), PS (≥2, HR: 2.90, 95%CI:
1.80-4.68, p < 0.001), stage (≥3, HR: 4.03, 95%CI: 2.42-6.71, p < 0.001), and AE (HR:
1.84, 95%CI: 1.26-2.69, p = 0.002) were significantly associated with OS, while in
SCLC, AE was the only significant prognostic factor (HR: 2.26, 95%CI: 1.08-4.73, p =
0.032).
Conclusions: The occurrence of AE is not rare in the lung cancer treatment,
particularly during chemotherapy, and it is a factor for poor prognosis in pts with
pre-existing ILD.
Disclosure: All authors have declared no conflicts of interest.
1539P PRIMARY MEDIASTINAL GERM CELL TUMOUR IN
PAKISTANI POPULATION; A SINGLE CENTER EXPERIENCE
K. Das, S. Imtiaz, S. Kumar, I.A. Muazzam, N. Siddiqui, S.A. Kazmi,
N. MuzzafarMedical Oncology, Shaukat Khanum Memorial Cancer Hospital and
Research Center, Lahore, PAKISTAN
Introduction: Primary mediastinal germ cell tumor (PMGCT) constitutes a rare
malignancy and is a diagnostic challenge because of the difficult approach and often
small size of the biopsy specimen. These tumours have a worse prognosis than their
gonadal counterparts. This study was performed to review clinical characteristics,
therapeutic strategies and outcome of patients with PMGCT at Shaukat Khanum
Memorial Cancer Hospital and Research Center Lahore Pakistan.
Patient and method: Medical records of patients treated in our hospital during 1996
to 2012 were retrospectively studied.
Results: Of 25 patients, 23 were males with a median age of 23 years (range 16–48).
Forty percent were seminoma and 60% were nonseminoma. More than 80% of
nonseminoma had raised baseline alpha feto protein. The clinical presentation in
order of frequency included; dyspnea (72%), cough (68%), chest pain (56%), pleural/
pericardial effusion (44%), weight loss (32%), fever (28%), superior vena-caval
obstruction (24%), cervical node metastasis (20%) and pulmonary metastasis (12%).
All were treated with initial standard platinum based chemotherapy. Eighty percent
of our patients achieved biochemical complete response and 80% achieved
radiological response (67% Partial response, 13% complete response). Median
survival of patients with seminoma was 37 months with three year survival rate of
60%. Median survival of patients with nonseminoma was 13 months with three year
survival rate of 31%. During study period eleven patients died (seven had disease
progression, 02 had bleomycin lung toxicity and two had neutropenic sepsis).
Conclusion: Nonseminoma constitutes the majority of primary mediastinal germ cell
tumors, with prominent male preponderance. Seminomas had a better outcome than
nonseminomas. Cisplatin based chemotherapy continues to be an effective treatment
for these tumours.
Disclosure: All authors have declared no conflicts of interest.
1540 COMPARISON OF SECOND LINE TREATMENT OUTCOMES
BETWEEN SENSITIVE AND REFRACTORY SMALL CELL LUNG
CANCER PATIENTS: A RETROSPECTIVE ANALYSIS
T. Korkmaz 1 , S. Seber 2 , E. Sari 2 , M. Canhoroz 3 , B. Oven Ustaalioglu 1 , U. Kefeli 1 ,
O. Balvan 1 , M. Gumus 4 , N. Yasar 1 , S.N. Turhal 5
1 Medical Oncology Department, Dr Lutfi Kirdar Kartal Research and Educational
Hospital, Istanbul, TURKEY, 2 Medical Oncology Department, Marmara University
Hospital, Istanbul, TURKEY, 3 Medical Oncology Department, Uludag University
Hospital, Bursa, TURKEY, 4 Dept. Medical Oncology, Kartal Research and
Training Hospital Division of Medical Oncology, Istanbul, TURKEY, 5 Medical
Oncology, Marmara University Hospital, Istanbul, TURKEY
Introduction: Small cell lung cancer (SCLC) has a high relaps rate despite being very
chemosensitive. The prognosis of these patients is generally poor. The efficasy of
second line treatment is dismal when compared to other chemosensitive tumors such
as germ cell tumor or lymphoma. Our aim was to evaluate the outcome of second
line treatment and to delineate the prognostic factors that would effect the survival
times and response rates.
Methods: Results we retrospectively assesed 120 SCLC patients who who failed
firstline platinum-etoposide chemotherapy and went on to receive second line
chemotherapy at 3 medical oncology centers.
Results: Median age of the study group was 58 (33-78) and %80 percent of our
patients were below 65 years old. %84 patient were male, %82 had an ECOG PS of
0-1. %61 were at extensive stage at the time of diagnosis. Patients who progressed
Volume 23 | Supplement 9 | September 2012 doi:10.1093/annonc/mds415 | ix497