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K. Hayashi



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    P2.24 - Poster Session 2 - Supportive Care (ID 157)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P2.24-017 - 5 cases of long-term survival in posterior spinal fixation surgery against vertebral metastasis of lung cancer (ID 1251)

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

      • Abstract

      Background
      Recently, with the progress of treatment, the patients showing prolonged survival has increased in advanced lung cancer. Even though local treatments for the patients with vertebral metastasis, such as radiation therapy and/or surgery, are considered with effective, the indication of the treatment has not been determined. We report 5 cases who underwent posterior spinal fixation, they could maintain ADL(Activities of Daily Livings) well and could keep a long-term prognosis.

      Methods
      Between December 2012 and June 2004, we objectively evaluate postoperative state and prognosis of the 5 cases that underwent the posterior spinal fixation surgery for vertebral metastasis in advanced lung cancer.

      Results
      5 patients were underwent this surgery, 3 were male and 2 were female and the average age was 58.9 years. We added the surgery to remove the pressure of the spine in 3 cases, fortunately there was no spinal invasion in these 5 cases. We preformed chemoradiotherapy in 4 cases and chemotherapy alone in 1 case. EGFR mutation was positive in 2 cases. All patients were possible to ambulate in early postoperative day, and they showed improvement of neurological symptoms of paralysis. It was possible to maintain a relatively well ADL.

      Conclusion
      There may be an excessive burden to perform the surgery for the patients with vertebral metastasis in advanced lung cancer, the surgery for selecting patients may have been able to improve neurological symptoms such as paralysis. Therefore, we thought that the surgical procedure for the patients who are possible to survive long term period might have been one of the important treatment methods because of maintaining possibly their ADL well.

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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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      P3.07-033 - Surgical treatments for NSCLC of female patients under 50 years old (ID 2704)

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

      • Abstract

      Background
      The number of patients with non-small cell lung cancer (NSCLC) has been increasing for some decades. The patients are predominantly male and over 50 years old in age, whereas female patients under 50 years old are relatively small cohort in NSCLC. Therefore, the characteristics of these female patients remain to be unclear.

      Methods
      In this study, we examined the clinico-pathological characteristics of female patients under 50 years old who had received surgical treatments for NSCLC. Female patients who had been under 50 years old and received curative surgical resection for NSCLC in our hospital from January 2000 to December 2010 were involved in this study. The clinico-pathological characteristics of them were examined retrospectively and compared with those of relative male patients in the similar criteria. Both overall survival (OS) and disease-free survival (DFS) times after surgery were obtained by Kaplan-Meier analysis, and differences between two cohorts were analyzed by log-lank test.

      Results
      In total, 13 female patients with median age of 43 years old (range: 40-49 years old) and 12 male patients with median age of 43years old (range: 31-49 years old) were received curative surgical resection for NSCLC in this period. All of the female patients were never-smokers, whereas 11 male patients (91.7%) were current smokers. Twelve female patients were free from symptoms at the diagnosis of NSCLC, however, 5 male patients had some symptoms related to NSCLC (a rate of symptom-free patients; female vs male = 92.3% vs 58.3%). Pathological stages of female NSCLC were as follows; 1A: 9, 1B: 1, 2A: 1, 3A: 1, 3B: 1. All cases of female NSCLC (100.0%) were diagnosed with adenocarcinomas histologically; mixed subtype: 6, papillary: 2, bronchiolo-alveolar cell carcinomas (BAC): 5 cases. In males, 8 patients (66.7%) were diagnosed with adenocarcinomas including 1 BAC case. The rates of OS and DFS at 5 years after surgery of female patients were 100.0% and 74.6%, respectively, with the median observation period was 69.0 months (range: 17-148 months). On the other hand, the rates of OS and DFS at 5 years after surgery of male patients were 74.6% and 58.3%, respectively, demonstrating that OS in female patients seemed to be long as compared with that in male patients (P=0.302).

      Conclusion
      More patients who were free from symptoms, never-smokers and with BAC subtype were included in female than male patients in this study. These characteristics of female patients would have contributed to the better prognosis of them after surgery. In the NSCLC patients under 50 years old, the prognosis of female patients who received curative surgery is likely to be better than that of male patients.