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H. Kato



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    P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P2.02-028 - Diagnostic and Therapeutic Benefits of Thoracoscopic Surgery in Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma (ID 469)

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

      • Abstract
      • Slides

      Background:
      Only a few reports have been published on pulmonary mucosa-associated lymphoid tissue lymphoma, a relatively rare disease. However, diagnostic and therapeutic surgery for this disease has increased recently due to the greater number of cases with indeterminate tumors detected by CT. We elucidated the characteristics of pulmonary mucosa-associated lymphoid tissue lymphoma and evaluated the role of thoracoscopic surgery.

      Methods:
      From March 2005 to March 2015, 13 patients underwent surgery for pulmonary mucosa-associated lymphoid tissue lymphoma diagnosed post-operatively. Three-dimensional CT simulation provides useful information for thoracoscopic surgery. We performed thoracoscopic lobectomy, anatomic segmentectomy, and subsegmentectomy for almost of these patients using the three-dimensional CT simulation. We evaluated patient characteristics, CT and FDG-PET findings, diagnostic methods, surgical procedures, operative time and bleeding, and prognosis.

      Results:
      The median age of the patients at surgery was 64 yr (range, 38–78 yr). All the tumors were solid nodules, with 11 patients having a single tumor and 2 patients multiple tumours. Median tumor size was 2.5 cm (range, 1.5-10 cm). FDG-PET showed SUV was 3.89-5.54 (range, 1.86-18.02). Only two patients were diagnosed preoperatively with mucosa-associated lymphoid tissue lymphoma by trans-bronchoscopic biopsies, while 11 patients were assumed preoperatively to have lung cancer and were diagnosed finally with the frozen section using a surgical approach. Ten of the 13 patients underwent resections with thoracoscopic surgery and 3 patients underwent resection with thoracotomy. The procedures were 6 lobectomies, 5 segmentectomies, and 2 wedge resections. The most recent case had a thoracoscopic lobectomy combined with a segmentectomy and subsegmentectomy. The mean surgical time and median bleed were 194 min and 9 mL and 215 min and 200 mL in the thoracoscopic and thoracotomy groups, respectively. These operative parameters were showing a tendency to reduce in the thoracoscopic group. No complications or recurrences occurred during the follow-up period (range 4- 120 mth, mean, 45.8 mth).

      Conclusion:
      Three-dimensional CT simulation was very useful and safely enabled reliable thoracoscopic segmentecomy and subsegmentectomy. Thoracoscopic surgery for pulmonary mucosa-associated lymphoid tissue lymphoma in which preoperative diagnosis is difficult can be performed safely and is beneficial for diagnosis and curative treatment.

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