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K. Chung



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    P1.06 - Poster Session 1 - Prognostic and Predictive Biomarkers (ID 161)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Biology
    • Presentations: 1
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      P1.06-008 - Expression of PTRF/Cavin-1 is associated with poor prognosis of lung adenocarcinoma (ID 933)

      09:30 - 09:30  |  Author(s): K. Chung

      • Abstract

      Background
      Polymerase I and transcript release factor (PTRF)/Cavin-1 was initially　identified as a regulator of rRNA transcription in the nucleus. It then was demonstrated to be essential to the formation of mature caveolae at the plasma membrane. Recently, downregulation of PTRF/Cavin-1 was reported in several types of cancers including non-small cell lung cancer compared to normal tissue. However, its precise expression pattern and clinical significance in lung adenocarcinoma remains unclear.

      Methods
      Proteomic analysis of 12 lung adenocarcinomas and the paired non-cancer lung tissue were preformed using iTRAQ coupled LC-MS/MS. To determine the expression pattern of PTRF/Cavin-1, we then performed immunohistochemical staining of PTRF/Cavin-1 on 186 adenocarcinoma tissues completely resected at Osaka City University Hospital from January 2005 to December 2008. To evaluate the clinical significance of PTRF/Cavin-1, the relationship between PTRF/Cavin-1 expression and clinicopathological parameters was analyzed.

      Results
      Proteomic analysis shows that expression level of PTRF/Cavin-1 is significantly lower in the cancer compared to the paired non-cancer lung tissue. This result suggests that PTRF/Cavin-1 may be involved in the development of lung adenocarcinoma. Immunohistochemistry analysis reveals that 30 cases (16%) were strongly positive for PTRF/Cavin-1 as observed in the non-cancer lung tissues, while 158 cases (84%) were negative. Furthermore, we found that overall survival rate of PTRF/Cavin-1-positve cases was significantly lower than that of negative cases (Log-rank test, p=0.0010). These findings imply that PTRF/Cavin-1 in cancer cells may facilitate the progression of lung adenocarcinoma progression.

      Conclusion
      These findings indicate that expression of PTRF/Cavin-1 in adenocarcinoma is associated with poor prognosis and might be a useful prognostic marker for lung adenocarcinomas.

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    P3.12 - Poster Session 3 - NSCLC Early Stage (ID 206)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P3.12-019 - Feasibility and efficacy of radical local therapy for Oligo-Recurrence of NSCLC (ID 3227)

      09:30 - 09:30  |  Author(s): K. Chung

      • Abstract

      Background
      Oligo-Recurrence (< 5 metastatic lesions) of surgically resected Non-Small Cell Lung Cancer (NSCLC) patient was stage IV disease, but long term survival was expected. Radical local therapy may be able to cure a subset of these patients, but clinical data has been insufficient.The purpose of this study is to evaluate the efficacy and toxicity of local therapy (include surgery (OP) and radiation therapy (RT)) according to the recurrence site.

      Methods
      We retrospectively reviewed surgically resected patients of NSCLC at our institution between 1994 and 2009, and extracted patients who received local therapy after recurrence. Efficacy and toxicity were compared between OP and RT. Significant differences among treatment groups were compared using the X[2]-test and survival curves were constructed using the Kaplan-Meier method and log-rank test.

      Results
      Of the 1975 patients who underwent surgery during this period, and 421 cases were relapsed. Two hundred sixty patients were oligo-recurrence case and were received local therapy (OP: 48/ RT: 143). Primary lesion had been controlled in all cases. Recurrence sites were lung: 55 (21/ 34), Brain: 52 (3/49), Mediastinal and neck LN: 49 (7/38), Born: 33(3/30) and Adrenal gland: 7 (3/4). RT for brain metastasis was r-knife: 38 and Whole brain irradiation: 11. There were no serious adverse events in both treatments. Performance status was not spoiled in both treatment groups. Overall median survival time (MST) after recurrence was 17 months (mo.) (OP: 27/RT: 11), 3-year survival rate was 22% (29%/19%). Twenty patients (OP 6/RT 6) were survived over 5 years. MST according to the recurrence site was, lung: 23 mo. (27/11), Brain 18 mo. (16/18), mediastinal and neck LN 14 mo. (12/14), born 12 mo. (17/11) and adrenal gland 26 mo. (22/47). There was no statistically significant difference in survival for overall patients, according to the recurrence site, and also treatment modality.

      Conclusion
      Local therapy for oligo-recurrence NSCLC could be safety performed. Overall survival data was not extremely superior to other Stage IV disease in this data. However, according to the recurrence site, MST of lung and adrenal gland were over 20 months. There was no significant difference between treatment modality. To confirm the true efficacy of radical local therapy for these patients, prospective study must be needed.

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    P3.24 - Poster Session 3 - Supportive Care (ID 160)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P3.24-019 - Local management of NSCLC with operable primary lesion and synchronous solitary brain metastasis (ID 1223)

      09:30 - 09:30  |  Author(s): K. Chung

      • Abstract

      Background
      The treatment for non small cell lung cancer (NSCLC) with operable primary lesion and solitary brain metastasis has not formed but the combined local therapy with surgical pulmonary resection of primary lesion and curative neurosurgical intervention of solitary brain metastatic site is becoming a standard option for such patients. The purpose of this study is to assess the efficacy and safety of the combined local therapy for NSCLC with operable primary lesion and solitary brain metastasis.

      Methods
      Within 1781 NSCLC patients underwent surgical resection from December 1993 to December 2010 at Osaka City General Hospital, 11 cases with synchronous (within 1 month of the primary NSCLC diagnosis) solitary brain metastasis and treated with curative neurosurgical intervention were identified. We retrospectively reviewed these cases and analyzed the treatment, pathology, prognosis and prognostic characteristics. Overall survival was recorded from the date of lung surgery until the last follow-up observation.

      Results
      The study group consisted of 7 male and 4 female. The median age at the time of pulmonary resection was 57 years (range, 39-76 years). The histological subgroup was adenocarcinoma in 10 cases and large cell carcinoma in 1 case. Neurological symptoms as the initial symptom were recognized in 3 cases. Type of pulmonary resection for primary lesion were lobectomy in 10 patients and sleeve lobectomy in 1 patient, and lymphatic extension was pN0 in 7 patients and N1-2 in 4 patients. All patients received gamma knife stereotactic radiosurgery (GKSRS) for management of the solitary brain metastasis and curative neurosurgical resection was performed in 1 patient before GKSRS. Both pulmonary resection and neurological intervention caused no serious adverse events. Of 11 patients, 7 patients had died of disease and 4 patients (3 with pN0 and 1 with pN1) were alive and with disease. The median overall survival time was 14 months and the 3-year overall survival rate was 36.4%.

      Conclusion
      The aggressive combined local therapy with pulmonary resection and neurological intervention for NSCLC patients with operable primary lesion and synchronous solitary brain metastasis should be considered effective and safe for selected patients. The multicentre prospective randomized studies are required to clarify the effectiveness and optimal method of this local treatment for such patients.