Abstracts / 50 (2014) e1–e74
Methods: We retrospectively reviewed contrast-enhanced CT scans and clinical records of 66 patients with RCC who fulﬁlled speciﬁed inclusion criteria. Patients who had bone metastases at the time of presentation were selected as cases and those without skeletal metastates were referred to as controls. Receiver-operating characteristic (ROC) curve analysis was used to determine the appropriate cut-oﬀ value for tumour size, which was measured as the sum of longest tumour diameter (SLD). Findings: Of the 66 patients selected, 30% developed bone metastases. Our results showed that tumour size of RCCs signiﬁcantly correlated with the presence of skeletal metastasis. None of the patients with an SLD of less than 4.8 cm on contrast-enhanced CT were found to have skeletal metastases. ROC analysis revealed that the accuracy of the SLD in predicting bone metastasis was high with an area under the ROC curve of 0.823. A cut-oﬀ value of 7.5 cm had a sensitivity of 78.9% and a speciﬁcity of 80.9%. Interpretation: Our data suggest that an SLD cut-oﬀ value of 7.5 cm at the time of presentation is an important predictor of skeletal metastasis. The results of this study may have a role in the triage of patients into a subgroup that mandates more aggressive treatment and monitoring.
P0010 THE ROLE OF SURGERY IN THE TREATMENT OF NONHODGKIN LYMPHOMA WITH GASTRIC INVOLVEMENT: ANALYSIS OF CASES TREATED AT A UNIVERSITY HOSPITAL IN BRAZIL OVER THE PAST 16 YEARS L.G. Lourenco *, D. Nogueira, T. Andrade, N. Borges, R. Colleoni, G. Colleoni. Universidade Federal De Sa˜o Paulo, Sa˜o Paulo, Brazil Background: Primary gastric lymphomas are non-Hodgkin lymphomas that originate in the stomach and are divided into low-grade and high-grade types. Low-grade lesions nearly always arise from mucosaassociated lymphoid tissue (MALT) secondary to chronic Helicobacter pylori infection and disseminate slowly. High-grade lesions may arise from a low grade-MALT component or arise de novo and can spread to lymph nodes, adjacent organs and tissues, or distant sites. Our aim was to analyse the cases of non-Hodgkin lymphomas with gastric involvement treated at a university hospital in southeastern Brazil and to assess the role of surgery in their treatment. Methods: We did a survey of cases of gastric lymphoma treated at Hospital Sa˜o Paulo-UNIFESP from 1996 to 2012. Findings: A total of 626 cases were diagnosed with non-Hodgkin lymphoma, 30 cases with gastric involvement (5%). Among these, 19 cases were female and 11 were male, with a median age of 56.5 years. Fourteen cases were diagnosed as extranodal marginal zone lymphoma of MALT: 10 were H pylori (HP)-positive, one was HPnegative, and three had unknown HP status. Fourteen cases were diagnosed as diﬀuse large B-cell lymphoma (DLBCL) and two cases as post-transplant lymph proliferative disorders (PTLD). 70% had localised disease (I–II). Twelve cases of MALT were treated with antibiotic therapy, followed by chemotherapy or radiotherapy (refractory cases), and two patients were treated solely with antibiotics. DLBCL cases received chemotherapy with an anthracycline-based regimen (recently associated with immunotherapy) and adjuvant radiotherapy in cases of localised disease. PTLD cases were treated with a reduction in immunosuppression and R-CHOP. Only 10 cases (33%) underwent surgery, the last in 2003. Interpretation: HP was present in almost all cases of MALT, determining the therapeutic choice. DLBCL were treated systemically with chemotherapy/immunotherapy, followed by adjuvant radiotherapy in
localised disease. There has been no indication for surgery in our hospital for this pathology for the past 10 years, and surgery is currently restricted to complications such as perforation and haemorrhage.
P0011 PAEDIATRIC ACUTE MYELOID LEUKAEMIA EXPERIENCE IN A TERTIARY CANCER CENTRE IN SOUTHERN INDIA C. Thampy *, V. Radhakrishnan, P. Ganesan, R. Rajendranath, T.S. Ganesan, T.G. Sagar. Cancer Institute, Chennai, Tamil Nadu, India Background: Paediatric acute myeloid leukaemia (AML) may have a diﬀerent biology from adult AML. Furthermore, diﬀerent paediatric groups from across the world use diﬀerent protocols to treat the disease. There are no data to show whether a standard 3 + 7 approach used in adult patients would be an adequate therapy for paediatric AML. Methods: We retrospectively analysed the outcomes of all consecutive paediatric AML patients treated at our centre from January 2008 to May 2013. Overall survival (OS) and progression-free survival (PFS) were estimated using Kaplan–Meier methods, and outcomes were compared across the patient parameters and treatment regimens used. The treatment regimens were DA (daunorubicin [DNR] 60 mg/m2 for 3 days and cytarabine [Ara-C] 100 mg/m2 for 7 days) in 39/65 (60%) patients and ADE (Ara-C 100 mg/m2 intravenously twice daily for 10 days plus DNR 50 mg/m2 for 3 days plus etoposide 100 mg/m2 for 5 days) in 26/65 (40%) patients. Findings: Sixty-ﬁve patients with a median age of 9 years (1–17 years) were included in the study, 45 (69%) of whom were male. The commonest subtype was M2 (26%). According to conventional cytogenetics, patients were classiﬁed as good risk (n = 18, 27%), intermediate risk (n = 13, 20%) and high risk (n = 12, 18%). A total of 72% of patients (47/65) attained complete remission (24/39 [62%] in the DA group versus 23/26 (88%) in the ADE group; p = 0.52). Median OS was 14.7 months (95% conﬁdence interval 4.4–24.8) and was not significantly diﬀerent between the two treatment regimens (37 months in the DA group versus 40 months in the ADE group; p = 0.4). There were more grade 4–5 haematological toxicities in the ADE group than in the DA group, but the diﬀerences were not signiﬁcant. The only factor that predicted the outcome was cytogenetic risk stratiﬁcation (OS in good-risk patients according to cytogenetics was 65%; p = 0.004). Interpretation: Even though a high complete response rate was achieved with both regimens, OS was still poor because of disease relapses among the intermediate-risk and high-risk patients. Increasing coverage with allogeneic stem-cell transplantation in both intermediate and high-risk cytogenetic patients might help to improve outcomes.
P0012 THE NANOPARTICLE QUILLAJA SAPONIN KGI EXERTS ANTI-PROLIFERATIVE EFFECTS BY DOWN-REGULATION OF CELL CYCLE MOLECULES IN U937 AND HL-60 HUMAN LEUKAEMIA CELLS S. Berenjian, K. Hu, M. Abedi-Valugerdi, M. Hassan *, S. Bashir Hassan, B. Morein. Experimental Cancer Medicine, Department of Laboratory Medicine, Karolinska Institutet, Solna, Sweden