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H. Nitanda



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    P2.14 - Poster Session 2 - Mesothelioma (ID 196)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Mesothelioma
    • Presentations: 1
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      P2.14-010 - Intrapleural Perfusion Hyperthermo-Chemotherapy with Cisplatin in Patients with Malignant Pleural Mesothelioma. (ID 3360)

      09:30 - 09:30  |  Author(s): H. Nitanda

      • Abstract

      Background
      For patients with malignant pleural mesothelioma (MPM), intensive local regulations are needed,whether patients will be treated with EPP or not. In order to obtain adequate control of malignant effusion and expect temporary anti-tumor effect, we have introduced intrapleural perfusion hyperthermo-chemotherapy (IPHC) with cisplatin.

      Methods
      Twenty-six patients with MPM underwent IPHC at the time of pleural biopsy with thoracoscope. Hyperthermo(42.5 ℃)-perfusion was performed with cisplatin (80mg/m[2]) during 60 minutes under the general anesthesia. Complications, control of pleural perfusion, treatment followed by IPHC, and survival time, were studied.

      Results
      Median age was 68 years (range, 56-82). Twenyy-four patients were male. Eiteen patients had epitherial, 5 had biphasic,and 3 had sarcomatoid histology. Fifteen had left-sided disease. There were no serious clinical complications associated with this procedure. The pleural effusion was well controlled in all patients. Adjuvant chemotherapies (CT) were performed immediately in 24 patients. Nine patients were treated by EPP after 2 course of CT: One/2/5 year survival rates were 87.5/50.0/37.5 %, respectively. MST was 19.5 months.Seventeen patients were treated by CT (platinum + Pem) : One/2 year survival rates were 81.9/29.8 %, respectively. MST was 14.0 months.

      Conclusion
      IPHC with cisplatin is easy to perform, and relatively safe. This method had brought an ideal pleural adhesion. IPHC may offer excellent local control and good survival for patients with MPM as a part of multi-modality therapy.

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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P3.07-041 - Study on surgical cases for simultaneous multiple GGNs in bilateral lung (ID 3021)

      09:30 - 09:30  |  Author(s): H. Nitanda

      • Abstract

      Background
      In recent years, the opportunity to encounter a ground glass opacity nodule (GGN) by high-resolution CT is increased, and simultaneous multiple GGNs also are not uncommon. A GGN has been usually classified as pure GGN and part-solid GGN, the former seems to correspond to atypical adenomatous hyperplasia (AAH) or adenocarcinoma in situ (AIS) and the latter seems minimally invasive adenocarcinoma (MIA) or invasive adenocarcinoma (IA), but CT image and pathological findings do not necessarily match. Some GGNs are diseases unrelated to primary lung adenocarcinoma. We have examined the resected cases for simultaneous multiple GGNs on both sides of the lung.

      Methods
      Adaptation of resection for GGNs on our hospital is as follows. 1)10-15mm or more size, 2) larger solid component, 3) just below the pleura, 4) increase over time in size or density, 5) the purpose of pathological diagnosis, etc. The prevention of lung function is noted in the resection on both sides of the lung. In this four years, we performed surgery on seven patients with bilateral multiple GGNs for diagnosis and treatment. We investigated the clinical features and histopathological findings of the resected lung.

      Results
      The seven patients consisted of 40 to 70 years old, five women and two men. We performed lobectomy and partial (wedge) resection of three patients. Four patients underwent several wedge resections for pathological diagnosis and treatment. Two women did the two-term surgery on both sides of the lungs. Pathological diagnosis was adenocarcinoma (AIS, MIA, IA) in five cases, AAHs in one, and lymphoproliferative disease in one. In one patient, all three lesions from four wedge resections had different mutated patterns of EGFR. There was no recurrence or death in 13 to 58 months of the observation period.

      Conclusion
      Simultaneous multiple GGNs was more frequent in women than men. Surgical biopsy (wedge resection) seems to be necessary for definitive diagnosis because a GGN may not be related to lung cancer. Even if multiple cancers in bilateral lung are supposed, prognosis may be able improved by surgical removal of more invasive (advanced) lesions in GGNs.