Page 130 - Livre électronique des Rencontres Franco-Tunisiennes de Pneumologie 2019

P86. SUPERIOR VENA CAVA SYNDROME AND LUNG CANCER: PROGNOSTIC FACTORS
AND SURVIVAL

LOUED LOBNA, FAHEM NESRINE, BEN SAAD AHMED, RHILA RIM, MIGAOU ASMA, CHEIKH
MHAMED SAOUSSEN, JOOBEUR SAMEH, ROUATBI NACEUR
SERVICE DE PNEUMOLOGIE, CHU FATTOUMA BOURGUIBA MONASTIR

Introduction :

The superior vena cava syndrome is a group of clinical manifestations related to the interruption
of the superior vena cava. Its etiologies are numerous but dominated by neoplastic causes mainly
of bronchopulmonary origin.
Aim :

The aim of this study is to identify and analyze the prognostic factors of SVCS in patients with lung
cancer and to evaluate the survival.

Methods :
It is a retrospective study, we collected data from the records of patients followed for SVCS due
to primary bronchopulmonary cancer in the Department of Pneumology, Fattouma Bourguiba
University Hospital in Monastir during a period of 25 years. A univariate and multivariate study
were conducted to determine the prognostic factors of SVCS.

Results :
One hundred eight patients with SVCS complicating primary bronchial cancer were enrolled. The
results showed the existence of a clear male predominance (98.1%) and the average age was 60.2
years. The superior vena cava syndrome revealed the neoplasm in 55% of cases and it was
metachronous in 30.5% of cases. The management of the SVCS is multidisciplinary; it includes
medical treatment and urgent decompressive radiotherapy that remains the gold standard. In
nivariate analysis, the survival was reduced in patients aged less than 60 years (6±1.07 VS 7±0.81
months; p=0.28), current smokers (8 ± 1.57 VS 6 ± 0.69 months; p=0.01), underweight (p=0.07) and
those with PS score ≥ 2 (8±0.60 VS 3.5± 0.79 months ; p0.001). Patients treated with chemotherapy
or radiotherapy had better survival than those who only had symptomatic treatment (p0.001). In
multivariate study, the independent factors of poor prognosis were male sex, smoking, general
impairment and signs of severity of SVCS.

Conclusion:
SVCS is frequent in patients with lung cancer and it is linked to a high mortality. Early detection
and adequate treatment of SVCS are the key to a better survival.

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