Abstract Book Society of Surgical Oncology 66th Annual Cancer Symposium National Harbor, Maryland March 6-9, 2013 Electronic supplement to Annals of Surgical Oncology An Oncology Journal for Surgeons Annals of Surgical Oncology An Oncology Journal for Surgeons The Official Journal of the Society of Surgical Oncology Abstract Book Society of Surgical Oncology 66th Annual Cancer Symposium National Harbor, Maryland March 6-9, 2013 CONTENTS Volume 20, Supplement 1, February 2013 S3: Session Titles and Abstracts Contents S5: Abstracts of Plenary, Parallel and Video Sessions S37: Abstracts of Poster Presentations S141: Conflict of Interest Disclosures S155: Author Index This supplement was not sponsored by outside commercial interests. Session Titles and Abstract Contents Session Title Abstract Numbers Pages Oral Presentations Plenary Session I 1, 2, 3 S6–S7 Plenary Session II 4, 5, 6, 7 S7–S8 Parallel Sessions: Breast Cancer 8 – 16 S8–S11 Parallel Sessions: Colorectal Cancer 17 – 24 S11–S14 Parallel Sessions: Endocrine Cancer 25 – 34 S15–S18 Parallel Sessions: Hepatobiliary Cancer 35 - 44 S18–S21 Parallel Sessions: Melanoma 45 - 53 S21–S24 Parallel Sessions: Quality Improvement/Clinical Outcomes 54 - 63 S24–S28 Parallel Sessions: Sarcoma 64 – 73 (68 withdrawn) S28–S31 Parallel Sessions: Upper Gastrointestinal Cancer 74 – 83 S31–S35 Top Rated Videos V1 – V7 S35–S36 Poster Presentations Posters: Breast Cancer P1 – P105 (P57, 90 withdrawn) S38–S71 Posters: Colorectal Cancer P106 – P145 (P137 withdrawn) S71–S83 Posters: Endocrine Cancer P146 – P152 S83–S85 Posters: Hepatobiliary Cancer P153 – P164 S85–S88 Posters: Melanoma P165 – P206 S88–S102 Posters: Other (Urology/Head and Neck/Thoracic) P207 – P240 (P236 withdrawn) S102–S111 Posters: Quality Improvement/Clinical Outcomes P241 - P274 S111–S122 Posters: Sarcoma P275 – P283 S122–S125 Posters: Upper Gastrointestinal Cancer P284 – P327 S125–S140 ABSTRACTS Accepted for PLENARY and PARALLEL SESSIONS 66th Annual Cancer Symposium Society of Surgical Oncology March 6–9, 2013 National Harbor, Maryland Ann Surg Oncol (2013) 20:S6–S164 DOI 10.1245/s10434-013-2877-x 1 orubicin/cyclophosphamide (AC X 4) vs. AC X 4 followed by paclitaxel X 4 Cytoreduction and HIPEC for Peritoneal Disease from Colorectal in 3060 pts. Pts ≥50 yrs and those <50 yrs with ER+ and/or PR+ tumors also Carcinoma in The Netherlands: Long-term Outcome of Procedures received tamoxifen. The present study includes 1065 ER+ pts, tamoxifen- Performed Under a Standardized Protocol A. Kuijpers,1* A. Aal- treated, and with RS assessment. Lumpectomy pts received breast radiation bers,1 S. Nienhuijs,3 I. De Hingh,3 R. Wiezer,2 B. Van Ramshorst,2 (XRT). Mastectomy pts received no XRT. Sub-distribution analyses were used R. Van Ginkel,4 K. Havenga,4 A. Bremers,6 L. Te Velde,5 H. De Wilt,6 for LRR to account for competing risks, including distant recurrence, second V. Verwaal.1 1. Dutch Cancer Institute - Antoni van Leeuwenhoek Hos- primary cancers, and death due to other causes. RESULTS: Median follow-up pital, Amsterdam, Netherlands; 2. Sint Antonius Hospital, Nieuwegein, was 11.2 yrs. There were 80 LRRs (7.5%) as first events (68% local/32% Netherlands; 3. Catharina Hospital, Eindhoven, Netherlands; 4. Uni- regional). RS was low in 36%, intermediate in 34% and high in 30%. RS was a significant predictor of LRR in univariate analyses (p<0.001, Table). RS versity Medical Centre Groningen, Groningen, Netherlands; 5. VU was significantly associated with LRR after lumpectomy + breast XRT and Medical Centre, Amsterdam, Netherlands; 6. University Medical Centre after mastectomy (no XRT) as well as in pts with ≥4 + nodes (with a non-sig- Nijmegen, Nijmegen, Netherlands. nificant trend in pts with 1-3 + nodes, Table). In multivariate regression analy- Question The HIPEC treatment for peritoneal surface malignancies from sis adjusting for treatment and type of surgery, RS remained an independent colorectal origin is now widely accepted worldwide. In the Netherlands, the predictor of LRR (HR: 2.61 [1.28-5.29] for a 50 point difference, P=0.008) treatment is only performed in dedicated centres that are trained by the first along with pathologic nodal status (HR: 1.91 [1.20-3.03] for ≥4 vs. 1-3 posi- centre. The treatment protocol of all hospitals in the Netherlands as well as tive nodes, P=0.007) and tumor size (HR: 1.28 [1.05-1.55] for a 1 cm differ- the data management is synchronized. In this study we assessed outcome in ence, P=0.015). CONCLUSIONS: RS significantly predicts risk of LRR in terms of disease-free survival and overall survival. Patients and methods The node (+), ER (+) BC pts after adjuvant chemotherapy plus tamoxifen. These six hospitals of which patients were included, performed the treatment under findings have clinical implications regarding selection of appropriate candi- a standardized protocol. Second procedures, open-close procedures and patients dates for comprehensive XRT. Supported by: NCI grants U10-CA-12027, - that underwent the HIPEC treatment for different pathology than colorectal 69651, -37377, -69974, U24-CA-114732, and CA-75362, Susan G. Komen for malignancies were excluded from analysis. Disease-free survival was meas- the Cure® grants, and Bristol-Myers Squibb Pharmaceutical Research Insti- ured from the operation date to the date of recurrence. Overall survival was tute measured from date of surgery to date of death or last follow up. Survival was illustrated by Kaplan-Meier curves. Results From 1995-2012, 967 patients that 10-year Cumulative Incidence in Percentage (95% CI) of LRR underwent HIPEC treatment were included in this study. Sixty percent of the According to the 21-Gene RS patients were female and 40% of the patients were male, with a median age of 58± 11.3 (range 21-81) years. Indications for CRS and HIPEC were peritoni- tis carcinomatosa (PC) from colorectal carcinoma in 69% of the cases and pseudomyxoma peritonei (PMP) in 31% of the cases. Median follow-up time was 41 months (range 0 to 186 months). Median progression-free survival was 34 months (95% confidence interval (CI) 30.5-37.5, Figure 1A). Median over- all survival was 47 months (95% CI 39.4-54.6) (Figure 1A). Median survival for PC from colorectal carcinoma was 33 months (95% CI 28.4-37.6) and for PMP 115 months (95% CI 80.0-150.0, p<0.001, Figure 1C). Conclusions Cytoreduction and HIPEC showed a median overall survival of 47 months for all the metastatic colorectal and PMP patients that underwent this treatment in The Netherlands. This indicates that the protocol used in the Dutch hospitals is a well-established and safe protocol with good long-term results. 3 Genomic and Functional Analysis of Myxofibrosarcoma Identifies HGF/MET and Integrin α10 as Potential Prognostic Biomarkers and Novel Therapeutic Targets A.Y. Lee,* N.P. Agaram, L. Qin, A.M. Crago, R.B. O’Connor, N.D. Socci, T. Okada, S. Singer. Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY. Introduction: Myxofibrosarcoma (MXF) has few effective systemic ther- apies. We sought to identify genomic subtypes of MXF and to identify genes that associate with outcome and could serve as therapeutic targets. Methods: Gene expression was profiled in 64 untreated primary MXF samples using U133A arrays. Profiles were analyzed by unsupervised clustering and corre- lated with disease-specific survival (DSS). Differentially expressed genes between the two main clusters were screened for independent association with DSS and the most significant genes/pathways were functionally evaluated using 2 shRNA knockdown and targeted drugs. Protein levels were assessed in pre- The 21-gene Recurrence Score (RS) Predicts Risk of Loco-regional operative serum by ELISA and in tumor tissue by immunohistochemistry. Recurrence (LRR) in Node (+), ER (+) Breast Cancer (BC) Dfter Results: Unsupervised clustering divided samples into 2 main clusters, which Adjuvant Chemotherapy and Tamoxifen: Results from NSABP B- differed significantly in DSS (72% vs. 91% at 2 years; p=0.021; Fig. 1). Dif- α 28 E.P.Mamounas,1* G.Tang,2 S.Paik,3 F.L.Baehner,4 Q.Liu,2 ferentially expressed genes included ITGA10 (integrin 10) and MET (a recep- J.Jeong,2 S.Kim,3 S.M.Butler,4 F.Jamshidian,4 D.B.Cherbavaz,4 tor tyrosine kinase). Both were independently associated with DSS (HR=2.46 A.P.Sing,4 S.Shak,4T.B.Julian,5 B.C.Lembersky,6 D.L.Wickerham,5 for ITGA10 and 7.25 for MET; both p<0.00005). Also associated with worse J.P.Costantino,2 N.Wolmark.5 1.NSABP Operations and Biostatistical DSS were serum levels of HGF (the MET ligand) and HGF and MET stain- ing in tissue. In 2 MXF cell lines with elevated MET the MET inhibitor Centers; Aultman Hospital, Canton, OH; 2.NSABP; University of Pitts- PF2341066 blocked HGF-induced invasion. In an MXF cell line, but not in a burgh Graduate School of Public Health Department of Biostatistics, normal adipose-derived stem cell line, ITGA10 knockdown decreased phos- Pittsburgh, PA; 3.NSABP, Pittsburgh, PA; 4.Genomic Health, Inc, Red- pho-MET and phospho-AKT levels, eliminated proliferation and induced 12- wood City, CA; 5.NSABP; Allegheny Cancer Center at Allegheny Gen- 17% apoptosis. Because SRC mediates integrin signaling, we tested the SRC eral Hospital, Pittsburgh, PA; 6.NSABP; University of Pittsburgh Can- inhibitor dasatinib on MXF cell lines with elevated ITGA10 or ITGA2 levels. cer Institute, Pittsburgh, PA. Dasatinib decreased MET phosphorylation, inhibited proliferation by 66-100%, BACKGROUND: RS predicts risk of distant recurrence in ER+ pts treated reduced migration by 48-59%, and reduced invasion by 66-90%. Conclusions: with adjuvant endocrine therapy. We evaluated the association between RS and MXF is genomically complex and diverse, but gene expression profiles clus- risk of LRR in node (+), ER (+) patients (pts) treated with adjuvant chemother- ter tumors into two distinct genomic subtypes that differ in outcome.