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Y. Shiraishi



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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
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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): Y. Shiraishi

      • 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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    P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
    • Presentations: 1
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      P2.08-027 - Investigation for the Optimum Resectable Pathological Size of Small Solitary Metastasis from Colorectal Cancers (ID 731)

      09:30 - 09:30  |  Author(s): Y. Shiraishi

      • Abstract

      Background:
      Surgery is still standard modality for the patients with pulmonary metastases from colorectal cancer in spite of recent remarkable development of chemotherapy. The aim of this multi-institutional retrospective study was to determine which pathological size is the best suited to pulmonary resection, and to evaluate the prognostic factors in the patients with small colorectal solitary metastasis.

      Methods:
      Patients and Methods Patients with pathologically solitary metastasis were recruited. The retrospective examined sample size was finally 561 who underwent complete resection at 46 facilities in Japan from 2004 to 2009.

      Results:
      No statistically significant difference was detected between with adjuvant chemotherapy and without in disease free survival (DFS) and overall survival (OS) (p=0.09 and p=0.79). Disease free survival (DFS) and overall survival (OS) calculated after initial pulmonary resection at 5 years were 71.0% and 41.7%, respectively. Tumors from 8-15mm in diameter showed the lowest incidence of recurrence in this series. Especially, relapse was occurred in all patients with pathological size 5mm (7/7, 100%) among the smallest group in the course of a median 279 days. Although significant difference was not found, a tendency was recognized with 15mm as the border by the recurrence proportion and the receiver operating characteristic curves for DFS. CEA abnormality, pathological size (more than 20 mm), and Disease free interval (more than 2 years) were the prognostic factors for DFS, whereas age (more than 70 years old), CEA abnormality, DFI (more than 2 years), and previous extrapulmonary treatment were the prognostic factors for OS in both univariate and multivariate analyses.

      Conclusion:
      Our multi-institutional retrospective study proposed that the optimum pathological size up to 15 mm was suitable to pulmonary resection in the patients with solitary metastasis from colorectal cancers, but the smallest nodules (less than 7 mm) had a possibility of re-recurrence within a median one year.