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A presumptive diagnosis of IP or an IP pattern on computed tomography (CT) was confirmed histologically by examination of resected specimens and/or the presence of the clinical diagnostic criteria. Acute exacerbation of IP was defined according to the guidelines of the Japanese Respiratory Society when the following criteria were fulfilled within 1 month: (1) increased respiratory distress; (2) fibrosis, newly developed ground glass opacity and infiltrative shadow on high-resolution computed tomography (HRCT); and (3) >10 Torr decrease in PaO 2 under the same oxygenation conditions. (4) no evidence of pulmonary infection, heart failure, pneumothorax, and pulmonary embolism. We studied the following clinicopathologic features in patients with lung cancer associated with IP: gender, age, surgical methods, pathologic stages, mortality rate, and post-operative complications, including acute exacerbation of IP. Result: Fifty-three patients underwent surgery. The mean age was 70.8 years (50 males and 3 females). Forty-three, 1, and 9 patients underwent lobectomies, a segmentectomy, and partial resections, respectively. Twenty-three, 17, and 13 patients were stage I, II, and III, respectively. Eight patients had postoperative acute exacerbations of IP and there were three in-hospital deaths caused by acute exacerbations. Of note, there have been no inhospital deaths since 2013. Conclusion: It is possible to prevent severe post-operative complications in patients with lung cancer associated with IP with the aid of intra-operatively and optimal peri-operative management.

Mesothelioma S149 patients. Since almost all mesothelioma patients will relapse, the choice of second line chemotherapy is important in clinical practice. Methods: This is a retrospective analysis of 98 patients diagnosed with malignant mesothelioma and treated with chemotherapy at our center. In these patients, we documented demographics, asbestos exposure, histological subtype, involvement of pleura or peritoneum, Eastern Cooperative Oncology Group Performance Status (PS), chemotherapy lines and agents, cycles of chemotherapy received and date of death. For the patients who received 2 nd line treatment we additionally documented PS at the initiation of 2 nd line treatment, best response by RECIST 1.1 criteria and we calculated Overall Survival (OS) from diagnosis, survival from initiation of 2 nd line therapy and Progression Free Survival (PFS) after 2 nd line therapy. Results: 50 patients received 2 nd line treatment. 48% of these patients received a taxane-gemcitabine doublet resulting in 0% Partial Response (PR), 21.74% Stable Disease (SD) and 69.57% Progressive Disease (PD). Patients had a 2.98 months median Progression Free Survival (mPFS), 15.34 months median Overall Survival (mOS) and 5.88 months survival from the initiation of 2 nd line therapy. 18% of the 2 nd line setting patients received docetaxel monotherapy. There were 0% PR, 0% SD and 55.56% PD. 22.22% discontinued due to toxicity and 11.11% due to deteriorating Performance Status. mPFS was 3.02 months, 22.96 months mOS and 5.48 months survival from the initiation of 2 nd line therapy. Finally 8 patients received the third most common 2 nd line option, rechallenge with either the platinumpemetrexed doublet (n = 6) or pemetrexed monotherapy (n = 2). 14.29% of them demonstrated PR, 57.14% SD and 28.57% PD. mPFS was 7.35 months, mOS 29.20 months and 11.13 months survival from the initiation of 2 nd line therapy. Conclusions: The heterogeneity of the three distinctive 2 nd line chemotherapy groups have a negative impact in the reproducibility and interpretation of the results. This study concurs with the literature in that until today no satisfactory 2 nd line chemotherapy agent exists for patients with mesothelioma. Legal entity responsible for the study: University of Athens Funding: University of Athens Disclosure: All authors have declared no conflicts of interest.