Meeting abstract in the European-Society-for-Medical-Oncology (ESMO) 21st World Congress on Gastrointestinal Cancer.info:eu-repo/semantics/publishedVersio

Barros, I.

Cunha, M.

Marreiros, A.

Martins, A.

Pinto Marques, H.

Annals of Oncology

English

Sapientia (Univ. do Algarve)

to EGFR inhibitors associated to chemotherapy (ChT), (2) to a VEGF inhibitor-associ-ated to ChT or (3) submitted to ChT without monoclonal antibody: the patients withRC cancer had an OS of 10,8mo. (CI 95% 6,81-14,79) in patients treated with EGFRinhibitors versus 26,3mo. (CI 95% 19,78-32,82) in patients treated with VEGF inhibi-tor versus 27,7mo. (CI 95% 23,05-32,35) in patients treated without monoclonal anti-body, p¼ 0,051. In LC cancer, the OS was 54,9mo. (CI 95% 31,81-77,99) in patientstreated with EGFR inhibitors versus 23,9mo. (CI 95% 16,68-31,12) in those treatedwith VEGF inhibitor versus 32,7mo. (CI 95% 19,71-45,69) in the others treated with-out monoclonal antibody, p¼ 0,007.Conclusion: The differences in RC versus LC survival were not statistically significative,but the OS was slightly different between each other, as described in the literature. InRC cancer the OS was superior in patients treated with VEGF inhibitors. On the otherhand, the OS in LC cancer was superior in patients treated with EGFR inhibitors.P 247 Splanchnic vein thrombosis in cholangiocarcinoma. A retrospectiveobservational study. Donostia University HospitalA Landa1, B Sanchez2, M Diaz3, M Ota~no3, A Medina3, C Fernandez Catalan3,A Santos4, L Izquierdo5, A La Casta Mu~noa31Hospital Universitario Donostia, Donostia, Spain, 2Hospital Universitario Donostia,Donostia, Spain, 3Donostia Universitary Hospital, San Sebastian, Spain, 4BiodonostiaResearch Institute, San Sebastian, , Spain, 5Biodosnotia Research Institute, SanSebastian, SpainIntroduction: Intra-abdominal neoplasms constitute themost important cause related tosplanchnic vein thrombotic (STV) events, followed by cirrhosis and inflammatory boweldiseases. SVT is a heterogeneous illness that could affect the portal vein system, hepaticvein system (Budd-Chiari Syndrome), splenic vein systemor uppermesenteric vein sys-tem. It is an infrequent issue with an incidence of 0.5-0.7/100.000 patients/year,much lessfrequent than deep vein thrombosis events. It can appear asymptomatically or with differ-ent symptoms depending on its localization. Our aimwas to describe the incidence andcharacteristics of splanchnic vein thrombosis events in a cohort of patients diagnosed withCholangiocarcinoma (CCA) in our center from January 2016 to June 2018.Methods:Data from biliary tract cancer (BTC) patients treated in our center fromJanuary 2016 till June 2018 were collected.We performed a retrospective search of SVTin our cohort and analysed data about diagnosis, treatment and follow-up of this event.Results: From January 2016 to June 2018 a total of 94 patients were diagnosed of BTCin our center, including intrahepatic CCA (iCCA), perihilar CCA (pCCA), distal CCA(dCCA), ampuloma and gallbladder cancer. 15 patients presented with an SVT event,an incidence of nearly 15%. 80% of those patients were iCCA and 20%were pCCA.67% of the patients hadmetastatic disease and 33% had locally advanced disease.Anyone of those 15 patients had been treated with surgery. 75% of the cases wereasymptomatic and all of themwere diagnosed incidentally by CT scan at the same timeas the primary tumour. When symptomatic, ascites and pain were the most frequentsymptoms. 50% of the patients were treated with low weight heparin with a stabiliza-tion of the thrombotic disease; two of them needed dose reduction due to chemother-apy-related thrombocytopenia. However, no case of thrombotic disease progressionwas observed among patients who did not receive anticoagulant therapy. When it refersto the localization of the SVT, 80% of the events were in the portal vein. Less frequentlythrombosis affected suprahepatic or vena cava.Conclusion: At the best of our knowledge, this is the first report about SVT in BTCpatients. In our cohort, 15% of the patients with CCAwere diagnosed with a splanchnicthrombotic event. Most of themwere locally advanced or metastatic iCCA.Thrombotic event was an incidental finding at diagnosis and behave asymptomaticallyexcept in four patients who developed ascites or pain. Indication and benefit of anticoa-gulation in those patients remains unclear. Treatment of this cancer complicationshould be evaluated in prospective clinical trials.P 248 Futility and utility of two-stage hepatectomyM Cunha1, I Barros2, A Marreiros3, A Martins2, H Pinto Marques21Centro Hospitalar Universitario do Algarve, Portim~ao, Portugal, 2Centro Hospitalar deLisboa Central, Lisboa, Portugal, 3Universidade do Algarve, Faro, PortugalIntroduction: A two-stage hepatectomy procedure (TSH)may be a curative approachfor patients with bilobar colorectal carcinoma liver metastases (CRLM). However, it isnot possible to complete this strategy as planned in about 20-40% of the cases. Aim: toidentify independent predictors for TSH strategy dropout.Methods: Patients that met criteria for TSH concerning CRLM, were studied(2000-2018; Tertiary hospital centre). Demographic and clinical evaluation wasperformed.Results: 196 patients, who were considered suitable for a TSH at baseline, ended up notcompleting this strategy (32.7%; n¼ 64). Progression of the underlying oncologic dis-ease was the main reason (70.3%). An adjusted multivariate classification approach wasused (dependent variable - complete or incomplete TSH; CRT algorithm): the variableswith the greatest discriminative power to explain strategy non-compliance were: Nfrom TNM staging (N0, N1a, N1c vs. N1b, N2a, b; p¼ 0.028), baseline Ca19.9 (cutpoint 49.9; p¼ 0.028) and CEA (cut point 27.2; p¼ 0.021). For those patients whocompleted the TSH procedure (n¼ 128), the 5-years overall survival was 35%.Conclusion: Predictive factors for TSH non-compliance were N staging, CEA andCa19.9 levels. Two profiles of patients with a higher probability of having anincomplete HDT strategy were identified: 1) N1b and N2 stagingþCa19.9 49.9; 2)N0; N1a and N1c stagingþCEA 27.2. According to the authors’ knowledge, this isone of the largest TSH series ever reported. Discriminating predictors of HDT dropoutmay be important to identify patients whomight not benefit from this strategy at theonset.P 249 Right-sided versus left-sided metastatic colorectal cancerW Ben Kridis1, A Mnif1, S khmiri1, J Feki1, I Ayedi2, N Toumi2, T Boudawara2, R Mzali2,A Khanfir31Habib Bourguiba Hospital, Sfax, Tunisia, 2habib bourguiba hospital, sfax, Tunisia,3Habib Bourguiba Hospital, sfax, TunisiaIntroduction: The aim of this work is to identify the clinical and prognostic character-istics of metastatic colorectal cancer according to its right or left localization in patientswho have had RAS status study.Methods: This was a prospective study of 40 patients followed for metastatic colorectalcancer collected in the university department of medical oncology in Sfax during a 2-year period (2017-2018) which looked at RAS status.Results: There were 9 cases of right-sided colorectal cancers (RS) and 31 cases of left-sided (LS). The mean age was 55.7 years in case of RS and 53 years for LS. The sex ratiowas 1 in the RS and 2 in the LS. Obesity was found in 50% of cases in each RS and LS.The colloid contingent was found in 50% of RS and 26% of LS. Metastases were meta-chronous in RS and synchronous in 91% of LS. The most commonmetastatic site wasperitoneum in RS (70%) and liver in LS (80%). Primary tumor surgery was performedin both cases in 70%. Eighty percent of the LS had peri-nerve or vascular invasion ver-sus 100% in the RS. The tumor was classified T4 and Nþ in 30% and 70% of the casesrespectively in each LS versus 50% and 100% in the RS respectively. The RAS wasmutated in 19% of LS and 25% of RS (p¼ 0.001). Themedian PFS was 13months and9months for each of the LS and RS (p¼ 0.03). The median overall survival was 23months and 18months for the LS and RS respectively (p¼ 0.02).Conclusion:Our study showed that RAS gene was mutated in RSmore than LS.Furthermore, it demonstrated that survival was significantly longer for patients withprimary tumors that originated on the left side of the colon.P 250 The combined treatment of 150 kHz Tumor Treating Fields(TTFields) and sorafenib shows In vitro and in vivo efficacy inhepatocellular carcinomaS Davidi1, K Gotlib2, E Zeevi1, R Shnaiderman1, T Voloshin1, M Giladi1, A Kinzel3,U Weinberg1, E Kirson1, Y Palti11Novocure, Haifa, Israel, 2Novocure, Hiafa, Israel, 3Novocure GmbH, Munich, GermanyIntroduction:Hepatocellular carcinoma (HCC) is the third cause of cancer-relatedmortality and the primary cause of cancer death. Sorafenib, an oral multikinase inhibi-tor is approved for patients with advanced HCC, yet its survival benefit is still limited.Tumor Treating Fields (TTFields) therapy is an effective anti-neoplastic treatmentmodality delivered via noninvasive application of low intensity, intermediate fre-quency, alternating electric fields. TTFields are employed as a local treatment with theintent to target dividing cells, leading tomitotic catastrophe and various forms of can-cer cell death. The aim of this work is to explore the potential of the use of TTFieldsalone and in combination with sorafenib as a treatment for HCC.Methods:HepG2 andHuh-7D12 cells were treated with various TTFields frequenciesfor 72 hours using the in-vitro system. Efficacy of the combined treatment of TTFieldsand sorafenib was tested by applying TTFields at the optimal frequency together withvarious drug concentrations. Cell counts, induction of apoptosis, cell cycle and clono-genic potential were determined. N1S1 HCC cells were injected to the left lobe of theliver of SD rats. After 1 week, TTFields (1.2 V/cm) and sorafenib were applied for 6 daysand tumor growth was followed usingMRI. Healthy rats were used to study the safetyof the use of TTFields (150 kHz) applied to the abdomen.Results: The optimal TTFields frequency was 150 kHz for both cell lines. TTFieldsapplication (1.0 - 1.7 V/cm, 72 hours) at 150 kHz led to 53-64% reduction in cell countsand to an additional reduction of over 70% in the clonogenic potential. The combinedtreatment of TTFields and Sorafenib led to a significant reduction in the number of cells(2-way ANOVA, p< 0.001) as compared to each treatment alone. Tumor growth wassignificantly reduced by the combined group compared to the control group (studentt-test, p< 0.01). Safety studies did not reveal any adverse event associated withTTFields application to the rat abdomen.Conclusion: These results demonstrated that TTFields can be a safe and effective treat-ment against hepatocellular cancer and that the combination with sorafenibmay fur-ther enhance treatment efficacy.abstracts Annals of Oncologyiv68 | Volume 30 | Supplement 4 | July 2019PostersDownloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_4/mdz155.247/5526529 by B-On Consortium Portugal user on 03 September 2019

P-248 Futility and utility of two-stage hepatectomy

Universidade do Algarve

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P-248 Futility and utility of two-stage hepatectomy

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