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S. Kakegawa



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    P2.16 - Poster Session 2 - Other Thoracic Malignancies (ID 187)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Thymoma & Other Thoracic Malignancies
    • Presentations: 1
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      P2.16-001 - Diagnosis and surgical resection of solitary pulmonary nodules in patients with breast cancer (ID 1266)

      09:30 - 09:30  |  Author(s): S. Kakegawa

      • Abstract

      Background
      The differential diagnosis of solitary pulmonary nodules (SPNs) in patients with breast cancer is vital but difficult using radiological features. We assessed the nature of SPNs in these patients and the role of surgery in diagnosis and treatment.

      Methods
      Thirty consecutive patients who underwent surgery for an SPN between 2002 and 2011 after curative surgery for breast cancer were retrospectively evaluated.

      Results
      Most (93%) SPNs were malignant. Pathological diagnoses in patients with SPNs were primary lung cancer (n = 20, 67%), pulmonary metastasis from breast (n = 7, 23%) or colon (n = 1, 3%) cancer, and benign conditions (n = 2, 7%). Among the 20 patients with primary lung cancer, 15 (75%) had stage IA tumors (T1aN0M0). The average disease-free interval was significantly longer in patients with primary lung cancer than in those with pulmonary metastases from breast cancer (P = 0.031). The five-year survival rates after pulmonary resection for lung metastasis from breast cancer patients and primary lung cancer patients were 100 and 61.1%, respectively.

      Conclusion
      SPNs found in patients with breast cancer have a high probability of malignancy, especially primary lung adenocarcinoma. Early resection of SPNs in patients who were diagnosed with both primary and metastatic lung cancer led to a good prognosis. We suggest that early pathological diagnosis by surgical resection should be conducted for the early diagnosis and appropriate treatment of SPNs in patients with breast cancer.

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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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      P3.07-036 - Postrecurrence survival of surgically resected pulmonary adenocarcinoma patients according to EGFR and KRAS mutation status (ID 2786)

      09:30 - 09:30  |  Author(s): S. Kakegawa

      • Abstract

      Background
      The aim of this study was to clarify the prognosis of pulmonary adenocarcinoma patients after postoperative recurrence according to EGFR and KRAS mutations and recurrence site.

      Methods
      Between July 2002 and December 2011, a total of 297 consecutive patients underwent surgical resection for primary pulmonary adenocarcinoma. Among all the patients, we retrospectively evaluated 58 recurrent adenocarcinoma patients. They were divided into the groups according to presence of EGFR mutation and KRAS mutation, and compared clinicopathological features, recurrence sites and postrecurrence survival.

      Results
      EGFR, KRAS mutations were detected in 26 patients (45%), 11 patients (19%), respectively. Of the cases with EGFR mutations, L858R point mutation in exon 21 was most frequently observed in 18 cases, secondly deletion in exon 19 was in 8 cases. Initial recurrence was detected in distant in 25 (43%), local in 17 (29%), and both in 16 (28%). In EGFR mutant (EGFR+) cases, bilateral/contralateral lung recurrences were significantly frequently occurred. EGFR+ cases had significantly better outcome than KRAS+ cases and EGFR-KRAS- (Wild) cases. 2-year postrecurrence survival rate were 81%, 18%, and 47% in EGFR+, KRAS+, and Wild cases, respectively. Patients with distant organ recurrence (D+) showed significantly worse survival than those without distant recurrences in only Wild cases, but not significant in EGFR+ cases and entire cohort. Multivariate analysis revealed that only EGFR mutation and number of recurrent lesions were statistically significant independent postrecurrence prognostic factors. Figure 1Figure 2

      Conclusion
      Our results indicate there were distinct survival differences in recurrent adenocarcinoma patients according to driver mutations. Patients with EGFR mutated tumors could be expected of long survive regardless of presence of distant site recurrences, and patients with KRAS mutated adenocarcinoma had poor outcome after postoperative recurrence. The examination of driver mutations is essential for prediction of postrecurrence survival after surgical resection.