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H. Kawai



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    P1.07 - Poster Session 1 - Surgery (ID 184)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P1.07-003 - Surgical indication for elderly lung cancer patients according depending on the mortality rate by due to other disease (ID 245)

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

      • Abstract

      Background
      As society ages, the incidence of lung cancer is increasing. Elderly patients with lung cancer are also more susceptible to other diseases than are younger patients.

      Methods
      In this study, 357 patients with non-small cell carcinoma, who underwent pulmonary resection at our hospital, were retrospectively reviewed. These patients were classified into 3 groups: Group A, 121 patients aged <64 years; Group B, 149 patients aged 65–74 years; Group C, 87 patients aged >75 years. The causes of death were investigated with a special focus on other diseases.

      Results
      The follow-up rate of all cases was 95.8%. One patient died of pulmonary embolism, and the operative mortality rate was 0.26%. Out of the 357 cancers, 71.1% had stageⅠ, 8.1% stageⅡ, and 20.1% stageⅢ. In Group A, 9.1% of the cases underwent wedge resection, 18.9% in Group B, and 47.7% in Group C. The proportion of wedge resection cases increased with age. In Group A, cancer-related survivals were 59.5%, 61.1% in Group B, and 66.7% in Group B, and there was no statistical significance between the groups. The overall survivals were 57.9％ in Group A, 55% in Group B, and 51.7% in Group C. There were significant differences between cases in Group C and those in other groups (p = 0.019, log rank test). Within 5 years of the operation, the mortality rates due to other disease were 1.6% in Group A, 6% in Group B, and 14.9% in Group C. Chi-squared test showed significant differences between cases in Group C and those in other groups. Twenty-four patients died due to other diseases: 5 from cardiovascular disease, 5 from respiratory disease, 5 from other malignant diseases, 3 from gastrointestinal disease, 1 from cerebrovascular disease, and 5 from other causes.

      Conclusion
      Since after lung-cancer surgery, the mortality due to other diseases increases in elderly patients, a postoperative survey or therapy for other diseases are important especially in elderly patients. Therefore, in order to prevent death due to other diseases or to enhance the quality of life until their death, a less-invasive surgery or limited resection to preserve respiratory function are more important in elderly patients than in younger patients

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    P1.16 - Poster Session 1 - Other Thoracic Malignancies (ID 186)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Thymoma & Other Thoracic Malignancies
    • Presentations: 1
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      P1.16-001 - Outcomes of surgical resection and radiofrequency ablation for lung metastasis from hepatocellular carcinoma (ID 1219)

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

      • Abstract

      Background
      The lung is the most frequently targeted organ for extra-hepatic metastasis from hepatocellular carcinoma (HCC). Pulmonary metastases account for 33.1% of extra-hepatic metastases from HCC. However, in most cases, pulmonary metastatic lesions are multiple and the prognosis of patients is poor. No standardized treatment for this condition has been established to date. Radiofrequency ablation (RFA) is commonly used for the local control of hepatic tumors. Recently, computed tomography-guided RFA has been indicated for lung tumors, and promising results have been reported. We analyzed the outcomes of surgical resection and RFA, used either alone or consecutively, for pulmonary metastatic lesions from HCC.

      Methods
      Eleven patients with lung metastasis from HCC underwent surgical resection alone, RFA alone, or surgical resection followed by RFA for pulmonary metastases from HCC. The initial treatment for pulmonary metastasis was surgical resection in 7 cases and RFA in 4 cases. Two patients who underwent surgical resection as initial treatment also received RFA. Seven patients were male, and the average age at initial treatment for the lung lesions was 69.8 years (range, 50–78 years). Surgical resection was indicated especially for lesions close to the visceral pleura and RFA was indicated for relatively medial lesions.

      Results
      The average number of metastases per patient was 1.8 (range, 1–4). Tumor size ranged from 5 to 40 mm. No treatment-related deaths or severe complications were noted. The median survival time for all cases was 25 months. Three patients survived for more than 3 years after initial treatment. Of these 3 patients, 2 underwent both metastectomy and RFA and 1 underwent metastectomy alone. At initial presentation, none of these 3 patients had extra-pulmonary lesions and all 3 patients had solitary lung metastatic lesions.

      Conclusion
      Local therapy comprising surgical resection, RFA, or both might be beneficial for the treatment of lung metastasis from HCC in cases with no extra-pulmonary lesions and few lung lesions. RFA is minimally invasive and can be performed under local anesthesia, without the loss of lung volume.