Virtual Library

 x 
My Library Virtual Library FAQ

Start Your Search

T. Igarashi



Author of

  • +

    P2.07 - Poster Session 2 - Surgery (ID 190)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
    • +

      P2.07-007 - Surgical treatment of elderly patients with resectable lung cancer (ID 832)

      09:30 - 09:30  |  Author(s): T. Igarashi

      • Abstract

      Background
      The incidence of lung cancer in the older population is increasing. In case of resectable primary lung cancer, surgery remains the best treatment for cure, independent of age. However, the prevalence of co-morbidities among elderly lung cancer patients is significantly higher. A presumed fear of increased postoperative morbidity and mortality in the elderly patients has resulted in the delivery of sub-optimal cancer surgery. We believe all elderly cancer patients should be offered optimal treatment depending on their functional status not on their age; a major step in ensuring this would be to establish the appropriate surgical management protocol for elderly cancer patients. Thus it is important to determine whether the elderly would indeed benefit from the same management standards as their younger counterparts. This study aimed to determine the suitable operative procedures for elderly patients with primary lung cancer.

      Methods
      Between January 2006 and December 2012, 98 patients aged over 75 years with primary lung cancer received lobectomies in our hospital. We divided the patients into group A (75-79 years old) and group B (over80 years old) and analyzed their relapse-free survival and postoperative complication incidence.

      Results
      The patients in group A (46 men and 17 women) had a mean age of 76.8 years, 36 patients had adenocarcinomas, 24 had squamous cell carcinomas, and 3 had other tumors. A mediastinal lymph node dissection (MLND) was performed in 52 patients but not in 11 patients. The patients’ pathological stages were 1A (21), 1B (13), 2A (5), 2B (12), 3A (11), and 4 (1). The 3-year relapse-free survival was 66.3 % (MLND-positive, 62.6 %; MLND-negative, 90.9 %). Postoperative complications occurred in 30.8 % of the MLND-positive patients and 18.2 % of the MLND-negative patients. The patients in group B (26 men and 9 women) had a mean age of 82.4 years, 17 patients had adenocarcinomas, 12 had squamous cell carcinomas, and 6 had other tumors. An MLND was performed in 24 patients but not in 11 patients. The patients’ pathological stages were 1A (12), 1B (10), 2A (5), 2B (3), 3A (1), and 3B (4). The 3-year relapse-free survival was 73.3 % (MLND-positive, 75.7 %; MLND-negative, 68.2 %). Postoperative complications occurred in 16.7 % of the MLND-positive patients and 9.1 % of the MLND-negative patients.

      Conclusion
      This study showed a survival benefit in elderly lung cancer patients who underwent lobectomies. In clinically well-documented early nodal stage disease (N0 patients and N1 patients with limited hilar disease), an MLND did not have a therapeutic effect and thus may not be necessary. Omitting MLNDs in elderly lung cancer patients also provided fewer postoperative complications. In this study, we proved that elderly patients with resectable lung cancer who received lobectomies without MLNDs could achieve long-term survival and be a safe procedure.

  • +

    P3.07 - Poster Session 3 - Surgery (ID 193)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
    • +

      P3.07-033 - Surgical treatments for NSCLC of female patients under 50 years old (ID 2704)

      09:30 - 09:30  |  Author(s): T. Igarashi

      • Abstract

      Background
      The number of patients with non-small cell lung cancer (NSCLC) has been increasing for some decades. The patients are predominantly male and over 50 years old in age, whereas female patients under 50 years old are relatively small cohort in NSCLC. Therefore, the characteristics of these female patients remain to be unclear.

      Methods
      In this study, we examined the clinico-pathological characteristics of female patients under 50 years old who had received surgical treatments for NSCLC. Female patients who had been under 50 years old and received curative surgical resection for NSCLC in our hospital from January 2000 to December 2010 were involved in this study. The clinico-pathological characteristics of them were examined retrospectively and compared with those of relative male patients in the similar criteria. Both overall survival (OS) and disease-free survival (DFS) times after surgery were obtained by Kaplan-Meier analysis, and differences between two cohorts were analyzed by log-lank test.

      Results
      In total, 13 female patients with median age of 43 years old (range: 40-49 years old) and 12 male patients with median age of 43years old (range: 31-49 years old) were received curative surgical resection for NSCLC in this period. All of the female patients were never-smokers, whereas 11 male patients (91.7%) were current smokers. Twelve female patients were free from symptoms at the diagnosis of NSCLC, however, 5 male patients had some symptoms related to NSCLC (a rate of symptom-free patients; female vs male = 92.3% vs 58.3%). Pathological stages of female NSCLC were as follows; 1A: 9, 1B: 1, 2A: 1, 3A: 1, 3B: 1. All cases of female NSCLC (100.0%) were diagnosed with adenocarcinomas histologically; mixed subtype: 6, papillary: 2, bronchiolo-alveolar cell carcinomas (BAC): 5 cases. In males, 8 patients (66.7%) were diagnosed with adenocarcinomas including 1 BAC case. The rates of OS and DFS at 5 years after surgery of female patients were 100.0% and 74.6%, respectively, with the median observation period was 69.0 months (range: 17-148 months). On the other hand, the rates of OS and DFS at 5 years after surgery of male patients were 74.6% and 58.3%, respectively, demonstrating that OS in female patients seemed to be long as compared with that in male patients (P=0.302).

      Conclusion
      More patients who were free from symptoms, never-smokers and with BAC subtype were included in female than male patients in this study. These characteristics of female patients would have contributed to the better prognosis of them after surgery. In the NSCLC patients under 50 years old, the prognosis of female patients who received curative surgery is likely to be better than that of male patients.