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D. Kato



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    P1.16 - Poster Session 1 - Other Thoracic Malignancies (ID 186)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Thymoma & Other Thoracic Malignancies
    • Presentations: 1
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      P1.16-003 - Features of computed tomography images and tumor viability: 141 lesions of pulmonary metastasis of non-seminoma (ID 1863)

      09:30 - 09:30  |  Author(s): D. Kato

      • Abstract

      Background
      The standard treatment for advanced non-seminoma is to excise all residual masses, including pulmonary metastatic lesions, in patients whose tumor markers return to normal after chemotherapy. However, too many regions and too great a volume of the patient’s lung are often resected. On the other hand, viable cells are frequently not present in the resected tissue. This study therefore tried to identify distinct features of viable lesions on computed tomography (CT).

      Methods
      Figure 1From January 2008 to December 2011, 17 cases of non-seminoma with lung metastasis underwent lung resection after normalization of tumor markers (α-fetoprotein and hCG). To excise all very small or impalpable lesions, we performed lipiodol marking under computed tomography, for a maximum of 8 sites in one operation. CT images of the 141 resected lesions were investigated for size and properties, and compared with pathological findings. Statistical analysis was performed using the chi-square test.

      Results
      We confirmed viable cells in 8 of 17 cases and 47 of 141 lesions. In those cases, viable cells were detected in both lungs. However, no significant relationship was found between average size and cell viability. The minimum diameter of tumor showing positive pathological change was 3 mm. No significant relation was observed between pathological findings and CT characteristics such as solid, cystic, scar-like or clear boundary.Figure 1

      Conclusion
      The ability to excise tissue from the lung is limited, and we would like to avoid excision of lesions against which chemotherapy has already been successful and which do not contain residual cells. However, the present results suggest the difficulty of specifying regions with viable cells based on CT. For this reason, minute lesions should still be excised, and marking has a very important role to play.