Author of

• 10962

  +

  P1.20 - Poster Session 1 - Early Detection and Screening (ID 172)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10973

    +

    P1.20-011 - Retrospective Study of Lung Cancer Screening. (ID 3372)

    09:30 - 09:30  |  Author(s): M. Fukui
    • Abstract

    Background
    The lung cancer screening in Japan is only chest radiography now. But in 2011, the national lung screening trial research team was reported reduced lung-cancer mortality with low-dose computed tomographic screening. We studied lung cancer patients about a difference of a screening type, for example radiography and computed tomography.

    Methods
    From January 2008 through May 2013, we performed the operation of 1344 lung cancer patients. In those patients, 1018 patients were proved the type of screening.

    Results
    

    symptom radiography CT pt 146 340 378 age 64±1 64±0.7 67±0.5 cStage IA 50 199 296 IB 22 66 42 IIA 18 25 6 IIB 15 13 8 IIIA 25 21 12 IIIB 6 4 2 IV 7 3 1 pStage IA 35 155 259 IB 18 57 53 IIA 12 31 13 IIB 16 23 11 IIIA 41 50 30 IIIB 6 4 1 IV 12 7 4

    The number of patients by symptom, radiography and computed tomography are 146 (14%), 340 (33%) and 378 (37%), respectively. The rate of clinical stage I (789, 78%) are 72 (7%), 265 (26%), 338 (33%), respectively. The rate of pathological stage I (672, 66%) are 53 (5%), 212 (21%), 312 (31%), respectively. On the other hand, the rate of clinical III are 31 (3%), 25(2%), 14 (1%), respectively. The rate of pathological III are 47 (5%), 54 (5%), 31 (3%), respectively. The difference of between clinical stage I and screening type are 0.000, 0.813, and 0.000, respectively. The difference of between pathological stage I and screening are 0.000, 0.081, and 0.000, respectively.

    Conclusion
    In the group of symptom and radiography, there are a lot of advanced lung cancer patients, while in the group of computed tomography, we can detect a lot of early lung cancer patients. Computed tomography is better than the other screening about the detecting lung cancer. We should use a computed tomography in screening of lung cancer.

• 12495

  +

  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12538

    +

    P3.07-043 - Pneumonectomy, bronchoplasty, pulmonary arterioplasty, and combined resections of the superior vena cava are feasible even in salvage surgery after treated lung cancer (ID 3084)

    09:30 - 09:30  |  Author(s): M. Fukui
    • Abstract

    Background
    Salvage therapy could be indicated for residual tumor and local recurrence of treated lung cancer. However, there is no report of the meaning of making full use of bronchoplasty, pulmonary arterioplasty, and combined resections of superior vena cava (SVC) in salvage surgery for lung cancer. In this study, we investigated perioperative complications of the salvage surgery for lung cancer according to the mode of operations.

    Methods
    We retrospectively reviewed 1320 consecutive patients who underwent lung resection for lung cancer at our institution from January 2008 to May 2013 and surveyed 18 salvage surgery cases among them. The mode of operation, perioperative complication and long-term outcome were investigated in detail.

    Results
    Twelve salvage surgical therapies were indicated for residual tumor after 10 chemotherapy and two chemoradiotherapy cases, and another six salvage surgeries were indicated for local recurrence after chemoradiotherapy. Radiation dose was 45 – 66Gy in seven chemoradiotherapy cases and 140Gy of proton therapy in one case. The number of mode of operation was as follows; one pneumonectomy with carinal resection, three pneumonectomies, one lobectomy with bronchoplasty and pulmonary arterioplasty and combined resection of the SVC (triple plasty), one lobectomy with bronchoplasty and combined resection of the SVC (double plasty), one sleeve bilobectomy, two sleeve lobectomies, eight lobectomies and one wedge resection(Table 1). Median operation time was 178.5 minutes (range 80-395). Median intra-operative blood loss was 130ml (range 5-1720). Average duration of hospitalization days after salvage surgery was 10.5 days. Regarding to operation time, intra-operative blood loss, and hospitalization days after operation, there was no significant difference between salvage surgery and conventional lung resection at our institute. Post-operative complications were as follows; three empyemas, three pneumonias, two pleural fistulas, and one chylothorax. We had to make an open window for one empyema case, but another complications were recovered safely and there was no 30-day mortality. Median follow-up was 9.5 months. There was no local recurrence but there were three distant metastases cases after salvage surgery. The longest survivor without recurrence after salvage surgery survives for 31 months.Figure 1

    Conclusion
    There were no critical complications and mortality in salvage surgeries after chemotherapy and chemoradiotherapy for lung cancer. Pneumonectomy, bronchoplasty, pulmonary arterioplasty and combined resections of the SVC are feasible even in salvage surgery for treated lung cancer.