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T. Ohtsuka
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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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P1.02-011 - The Discordance of Two Major Diagnostic Criteria for Chronic Obstructive Pulmonary Disease Affects Lung Cancer Prognosis after Resection (ID 1250)
09:30 - 09:30 | Author(s): T. Ohtsuka
- Abstract
Background:
Chronic obstructive pulmonary disease (COPD) has been reported to be associated with the development of lung cancer and poor prognosis after curative surgery for early-stage non-small cell lung cancer (NSCLC). The Global Initiative for Chronic Obstructive Lung Disease defines COPD as a fixed post-bronchodilator ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC) below 0.7. Age-dependent cut-off values below the lower fifth percentile (LLN) of this ratio derived from the general population have been proposed as an alternative. In patients with obstruction according to the LLN cut-off point but not according to the fixed cut-off point, the prognosis after curative surgery for NSCLC is not known.
Methods:
We enrolled 556 patients with FEV1/FVC ≥0.7 who underwent curative surgical resection for pathological stage I or II NSCLC in our institute between January 2002 and December 2012. The post-surgical prognosis was compared between patients with obstruction (obstructed patients) and without obstruction (non-obstructed patients) according to the LLN cut-off point, using a Cox regression hazards model.
Results:
Of the 556 patients, 42 (7.6%) met the criteria of the LLN cut-off point. The 5-year recurrence-free rate was significantly lower in the obstructed patients (54.4%) than in the non-obstructed patients (77.1%), in univariate analysis (p < 0.01). The 5-year overall survival rate was also significantly lower in the obstructed patients (64.0%) than in the non-obstructed patients (91.1%), in univariate analysis (p < 0.01). Multivariate analysis showed that the obstructed patients had a poor recurrence-free (p = 0.05) and overall survival (p < 0.01) probability.
Conclusion:
Even if COPD is not diagnosed according to the fixed cut-off point, those who meet the criteria of the LLN cut-off point have a poor prognosis after curative surgery for NSCLC.
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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
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-020 - Percutaneous Cryoablation for Pulmonary Metastasis of Soft Tissue and Bone Sarcomas (ID 352)
09:30 - 09:30 | Author(s): T. Ohtsuka
- Abstract
Background:
The treatment of pulmonary metastases of soft-tissue and bone sarcomas is challenging, as they are highly resistant to both chemotherapy and radiotherapy. Hence, while surgery is the treatment of choice, the treatment options are currently very limited for non-surgical patients. Therefore, the purpose of this study was to evaluate the safety and efficacy of percutaneous computed tomography (CT)-guided cryoablation for pulmonary metastases of soft tissue and bone sarcomas.
Methods:
Hospital records of patients who underwent cryoablation for metastatic lung tumors of soft-tissue and bone sarcomas were reviewed. Percutaneous cryoablation was performed using the Cryocare system (Endocare, Irvine, CA) and multi-slice CT fluoroscopy. CT scans were obtained immediately after the procedure; follow-up CT was performed on days 1, 7, 30, and 90, and subsequently at 6-month intervals. The procedural safety, local progression-free survival, and overall survival were assessed retrospectively.
Results:
Between 2002 and 2011, percutaneous cryoablation was performed on 20 patients (12 men and 8 women; median age, 46 years; age range, 17-83 years) for 56 metastatic lung tumors of soft tissue and bone sarcomas, during a total of 36 sessions. Of the 20 patients, 2 (10%) refused surgery and 18 (90%) were considered inoperable due to multiple tumors or insufficient pulmonary function. Of the 36 sessions, pneumothorax occurred in 12 (33%), transient hemoptysis in 11 (31%), and hemothorax in 1 session (3%). Of the 12 sessions with pneumothorax, 1 (8%) required chest tube insertion. No surgical intervention was required for any of these complications. With a median follow-up of 27 months, 2 tumors (4%) showed disease progression at the original cryoablation site. The local progression-free survival rates at 1 and 3 years after cryoablation were 95% each, and the 1- and 3- year overall survival rates were 77% and 49%, respectively. Four patients were alive over 5 years after cryoablation.
Conclusion:
Percutaneous cryoablation is a feasible and efficient treatment option for inoperable metastatic lung tumors of soft tissue and bone sarcomas.
