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T. Nakagawa
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P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.02-010 - What Is the Difference between Lung Cancer and Infectious Lung Disease in Predicted Postoperative Pulmonary Function after Pneumonectomy? (ID 3234)
09:30 - 09:30 | Author(s): T. Nakagawa
- Abstract
Background:
Clinical guideline recommends that spirometry and/or lung perfusion scan be performed for patients undergoing pneumonectomy. Unlike in patients with lung cancer, the affected lungs to be resected have been destroyed due to inflammatory changes in patients with infectious lung diseases. This study was aimed to assess whether there is any difference in predicted postoperative pulmonary function between patients with lung cancer and patients with infectious lung disease.
Methods:
The study was done on 55 patients undergoing pneumonectomy from January 2005 to February 2015, including 22 patients with lung cancer (three right, 19 left) and 33 patients with infectious lung disease (13 right, 20 left). Infectious diseases included 10 pulmonary aspergillosis, 15 multidrug-resistant tuberculosis (MDR-TB), and 8 non-tuberculosis mycobacterial (NTM) infections. In all cases, predicted postoperative pulmonary function was evaluated by spirometry and quantitative lung perfusion scan before operation. We analyzed the differences in patient characteristics and pulmonary function between the two groups, such as percentage of forced expiratory volume in one second (%FEV1), percentage of postoperative FEV1.0 (%ppoFEV1), and estimated postoperative epoFEV1/m2 (epoFEV1/m[2]).
Results:
The mean %FEV1 in spirometry was significantly higher in patients with lung cancer than in patients with infectious lung disease (79.5% vs 67.0%; p=0.01). The rate of perfusion to the operative lung was significantly higher in patients with lung cancer than in patients with infectious lung disease (35.8% vs. 19.3%; p<0.01). Consequently, the mean %ppoFEV1 was not significantly different between the two groups (51.8% vs 50.6%; p=0.72). Body surface area of lung cancer patients was larger than that of infectious lung disease patients (1.65m[2] vs 1.50m[2]; p<0.01). The mean calculated epoFEV1/m[2] after pneumonectomy in patients with lung cancer and in patients with infectious lung disease were 869ml/m[2] and 993ml/m[2] (p=0.05), respectively.
Conclusion:
Preoperative %FEV1 in patients with lung cancer was higher than that in patients with infectious lung disease. However, %ppoFEV1.0 and epoFEV1/m[2] after pneumonectomy were not different between the two groups. These differences were caused by destructive feature of infectious lung diseases.
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P2.05 - Poster Session/ Prevention and Tobacco Control (ID 216)
- Event: WCLC 2015
- Type: Poster
- Track: Prevention and Tobacco Control
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.05-010 - The Chronic Respiratory Infection as a Background of the Lung Cancers (ID 2636)
09:30 - 09:30 | Author(s): T. Nakagawa
- Abstract
Background:
It had been pointed out about the respiratory infectious disease that the tuberculosis patients had increased risk of lung cancers, and the lung cancer patients had increased risk of tuberculous infection. In recent years, primary lung cancer cases are increased, despite of decreasing of tuberculosis infection and, on the other hand, of increasing of chronic respiratory infectious diseases such as the pulmonary non-tuberculous mycobacteriosis or mycosis. A purpose of this study is to research the chronic respiratory infectious diseases as a background of the lung cancer treatment.
Methods:
From January, 2010 to December, 2014, 431 cases of radical operations for primary lung cancers were performed in our institute. A bacteriological search by the expectoration and bronchus absorption sputum was examined in 389 cases preoperatively. Among these cases, we retrospectively researched about the fungal infections and mycobacterial infections.
Results:
Among the 431 primary lung cancer cases, 19 cases of fungal infections were detected, 12 cases of non-tuberculous mycobacterium infections were detected, four were co-existing and none was tuberculosis. In the patient background of mycosis, gender was 15 cases of male and four of female, the mean age was 69.7±8.1 years old (53-88 years old), and mean smoking index was 1073 (0-2640). The histological types of the lung cancers were eight cases of squamous cell carcinoma, seven of adenocarcinoma, each one of small cell lung cancer, pleomorphic carcinoma and LCNEC. The pathological stages of the lung cancers were nine cases of stage I, five of stage II, four of stage III and two of stage IV. The detected species of bacteria were nine cases of Candida spp., eight of Candida albicans, two of Aspergillus fumigatus and one of Aspergillus niger. The patients had past history of tuberculosis in three cases, cancer in four, diabetes in 6 and continuous treatment by steroid in two. In the patient background of non-tuberculous mycobacteriosis, gender was 7 cases of male and 5 of female, the mean age was 71.7±10.2 years old (50-88 years old), and mean smoking index was 556 (0-1800). The histological types of the lung cancers were six cases of adenocarcinoma, three of LCNEC, two of squamous cell carcinoma, one of small cell lung cancer. The pathological stages of the lung cancers were eight cases of stage I, one of stage II, two of stage III and one of stage IV. The detected species of bacteria were 11 cases of Mycobacterium avium complex and one of Mycobacterium mucogenicum. The patients had past history of cancer in two cases and continuous treatment by steroid in two, but none of tuberculosis and diabetes. The five year survival rate of the lung cancer cases with the chronic respiratory infections was 63.0% and that without the chronic respiratory infections was 76.6%. The lung cancer cases with chronic respiratory infections showed tendency of poor prognosis, although there was no significant difference between two groups (p=0.087).
Conclusion:
The lung cancer cases with chronic respiratory infections had past history of coexisting disease, and showed tendency of poor prognosis.
