P9 Epidemiological survey suggests lung cancer is less common in patients with hereditary haemorrhagic telangiectasia compared to controls

Abstract

increased by 62% & 46% respectively from Group A to B although no evidence of any significant change in the proportion of patients having surgery compared with DXT was seen between Group A/B (p = 0.75). Compared with 2005 (n = 18), 29 patients underwent surgery in 2012 (p = 0.08). The proportion of wedge/segmentectomy resections (W/S) doubled over time although this change did not reach significance (p = 0.22). Similar non-significant changes in the proportion of surgical patients with stage 1 disease (p = 0.92), post-operative N2 disease (p = 0.81) and pre-operative histology (p = 0.58) were observed between Group A/B. In contrast, the rate of pre-DXT histology increased significantly from 34% to 65% (p = 0.0007). Overall concordancy between pre-operative and final histology was 97%. In 6 patients not having preoperative histology, the final diagnosis was malignant neuroendocrine tumour. Conclusions Improvements in the SLCS over the last 4 years have led to parallel rises in surgical and DXT rates. The rise in surgery numbers likely reflects better patient selection and increase in use of W/S whereas that for DXT appears to be the result of improved diagnostics reflected by significantly higher rates of histological diagnosis. Objectives Survival analysis, technical success, safety and imaging follow-up of malignant pulmonary nodules treated with microwave and radio-frequency ablation. Materials/Methods Between July 2010 and July 2012, 28 patients, 14 female, mean age 61 years (31-87) with 54 pulmonary malignancies of mean diameter 18 mm (6-59mm) underwent computed tomography (CT)-guided thermal ablation (radio-frequency ablation for two lesions, microwave ablation for the remainder). Bronchogenic carcinoma was treated in 15 patients, metastatic tumour in the remainder (tumours were diagnosed by biopsy (67%) and or PET/CT). Technical success was defined as needle placement in the intended lesion without death or serious injury. Adequacy of ablation was assessed at 24 hours on contrast-enhanced CT. Circumferential solid or ground glass opacification > 4mm was deemed adequate, and >5mm was deemed ideal. Patients were followed with contrastenhanced CT 3 monthly until death, or local tumour recurrence; Recurrence was identified by enlargement of the zone, the development of contrast enhancement in part of the zone, or a change in the shape of the ablation zone as a result of enlargement of one area. Survival rate was evaluated by Kaplan-Meier analysisResults Thermal ablation was technically successful in 98% (n = 50). Mean ablation duration was 5.2 minutes (1-24 minutes). 19(68%) patients developed a pneumothorax post procedure, 7 (25%) required a chest drain. 30-day mortality rate was 0%. The mean hospital stay was 1.3 days (1-7 days). Local recurrence was only identified in one patient at a median follow up of 12 months. The 1-year survival for all cause mortality was 68%; cancer-specific mortality yielded a 1-year survival of 75%. Conclusions Thermal ablation of pulmonary malignancies is a safe, successful techn...