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A. Sakurada



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    P2.20 - Poster Session 2 - Early Detection and Screening (ID 173)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      P2.20-001 - Effect of repeated annual sputum cytology screening on high risk population: change of incidence of squamous cell carcinoma (ID 278)

      09:30 - 09:30  |  Author(s): A. Sakurada

      • Abstract

      Background
      Sputum cytology is a widely accepted non-invasive diagnostic method for lung cancer. However, the efficacy to reduce lung cancer mortality has not been clearly proven in mass screening setting. To understand the potential value of sputum cytology to detect squamous cell carcinoma (SCC) of the lung, we evaluated its sensitivity and specificity. We simultaneously attempted to clarify the effect of repeated screening on the incidence of SCC.

      Methods
      In total, 104,872 sputum cytology tests combined with miniature chest X-ray were performed on 44,809 people belonging to the high-risk population of Miyagi Prefecture in Japan from 1990 to 1996. The sensitivity and specificity were calculated based on the information from the Cancer Registry. The incidence of SCC in the year after sequential annual repeat or sequential annual absences was analyzed.

      Results
      In total, 183 SCC-positive cases were diagnosed. The sensitivity and specificity of sputum cytology for SCC were 66.7% and 99.9%, respectively. Among cases with known localization, sensitivity for the central type was 90.7%, while that for peripheral type was 64.2%. Similarly, significantly decreased screen-detected SCC was observed in the third repeated test . A significant increase in screen-detected SCC cases was observed in the third year of sequential absence from screening.

      Conclusion
      Annual screening by sputum cytology for the high-risk group showed high sensitivity for SCC of the lung, particularly for central type SCC. Significantly reduced incidence of central type SCC was observed by repeating annual sputum cytology screening.

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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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      P3.07-005 - Recurrence-free and post-recurrence survival and the incidence of metachronous primary lung cancer after complete resection of non-small cell lung cancer (ID 229)

      09:30 - 09:30  |  Author(s): A. Sakurada

      • Abstract

      Background
      In patients with completely resected non-small cell lung cancer, recurrence-free and postrecurrence survival, and metachronous primary lung cancer, have not been well studied at the same time.

      Methods
      A total of 315 patients with non-small cell lung cancer who underwent complete resection between 2001 and 2005 were examined. Patients were routinely assessed with chest computed tomography scan and physical checkups every 4 months for the first 2 years, and every 6 months from the third to fifth year. After that, they were examined annually. Accordingly, surviving patients can be followed up for five years or more after surgery.

      Results
      Median recurrence-free survival was 15.7 months. Multivariate analysis showed that pathological stage and pleural invasion were associated with decreased recurrence-free survival (Fig1). Median postrecurrence survival was 18.7 months. Multivariate analysis indicated that male gender, pleural invasion, extrathoracic recurrence and supportive care for recurrence were associated with decreased postrecurrence survival (Fig 2). The cumulative rate of metachronous primary lung cancer at 5 years was 3.7 %, and it developed at even eight years after initial surgery. Figure 1

      Conclusion
      The long-term follow-up of patients with completely resected NSCLC revealed that recurrence-free survival was related to the pathological stage of the original lung cancer, but postrecurrence survival was not. Only pleural invasion of the original lung cancer was related to both recurrence-free and postrecurrence survival. Moreover, postrecurrence survival was related to both site and treatment of the initial recurrence. In brief, the more advanced stage a lung cancer is at, the earlier it recurs. However, after recurrence, postrecurrence survival is related to the recurrence site or type of treatment of recurrent disease, rather than original lung cancer stage. The incidence of metachronous primary lung cancer was stable over time after the initial surgery.