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Q. Ma
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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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P1.02-026 - For NSCLC with T3 (Central) Disease, Sleeve Lobectomy or Pneumonectomy? (ID 38)
09:30 - 09:30 | Author(s): Q. Ma
- Abstract
Background:
Pneumonectomy has traditionally been the treatment of choice for central lung tumors for which the alternative is sleeve lobectomy. The aim of this study was to compare early and long-term results after sleeve lobectomy and pneumonectomy in focusing on T3 central non-small cell lung cancer (NSCLC).
Methods:
Patients who underwent sleeve lobectomy (n = 58) or pneumonectomy (n = 42) were retrospectively analyzed. For bias reduction, these 100 patients had been selected according to the following criteria: (1) tumor located in the main bronchus less than 2 cm distal to the carina, (2) there was no N2 disease, (3) no induction therapy was applied, (4) a complete resection was achieved.
Results:
Sleeve lobectomy and pneumonectomy patients have had comparable mean ages, gender distribution, mean forced expiratory volume in 1 second, stage and tumor grade. Postoperative mortality (3.4% vs 4.8%, p = 1.0) and morbidity (41% vs 38%, p = 0.74) were similar between the two groups. Recurrences occurred in 48% of patients after sleeve lobectomy and in 31% of those after pneumonectomy (p = 0.08). The 5-year survival after sleeve lobectomy (64.8%) and pneumonectomy (61.4%) was not significantly different (p = 0.20). Multivariable survival analysis showed that there were no independent prognostic factors.
Conclusion:
Sleeve lobectomy does not compromise survival for NSCLC with T3 central disease compared with pneumonectomy. It is an adequate oncologic resection and should be treated as the first line intervention whenever complete resection can be achieved.
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P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-047 - Fibrobronchoscopic Cryorecanalization for Unresectable Secondary Malignant Tumors of the Trachea and Main Bronchi (ID 2367)
09:30 - 09:30 | Author(s): Q. Ma
- Abstract
Background:
Most patients with secondary malignant tracheobronchial tumors have distressing symptoms due to major airway obstruction. However, they are always too frail for curative surgical resection. We choose fibrobronchoscopic cryorecanalization to improve their life quality and analyzed the long time survival outcome.Most patients with secondary malignant tracheobronchial tumors have distressing symptoms due to major airway obstruction. However, they are always too frail for curative surgical resection. We choose fibrobronchoscopic cryorecanalization to improve their life quality and analyzed the long time survival outcome. file://localhost/Users/app/Documents/2014下半年/11122014%20JTO/冷冻/Figures/Figure%202.tif file://localhost/Users/app/Documents/2014下半年/11122014%20JTO/冷冻/Figures/Figure%201.tif file://localhost/Users/app/Documents/2014下半年/11122014%20JTO/冷冻/Figures/Figure%203.tif
Methods:
Clinical records of 14 patients were reviewed retrospectively from December 2005 to January 2013. A temperature from -50℃ to -70℃ was delivered to the central part of the tumor by cryo-probe for 4 to 6 minutes causing destruction of the tumor mass (Cryo-melt method). Subsequently, the edge of tumor was froze for 0.5 to 2 minutes and then tore the lesion piece by piece immediately with the advantage of concretion between the frozen probe tip and the tumor tissue (Cryo-resection method). file://localhost/Users/app/Documents/2014下半年/11122014%20JTO/冷冻/Figures/Figure%204.tif
Results:
The rates of dramatic and partial symptomatic alleviation were 57.1% and 28.6% respectively. There were no intraoperative deaths. The median survival was 16.0 months. Overall survival was 64.3% at half year, and 50.0% at 2 years. 2-year survival was significantly correlated to age (less than 60 years 22.2% versus more than 60 years 100%, p=0.011), tumor location (main bronchi 0% versus trachea 77.8%, p=0.003), and cryorecanalization times (one time 33.3% versus two or more times 80.0%, p=0.037). file://localhost/Users/app/Documents/2014下半年/11122014%20JTO/冷冻/Figures/Figure%205.tif file://localhost/Users/app/Documents/2014下半年/11122014%20JTO/冷冻/Figures/Figure%206.tif file://localhost/Users/app/Documents/2014下半年/11122014%20JTO/冷冻/Figures/Figure%207.tif
Conclusion:
Fibrobronchoscopic cryorecanalization is a safe, easily repeatable and effective minimally invasive choice for releasing the airway obstructive symptoms. In addition to high local-regional control rates, a rewarding result of prolonged survive time can also be obtained.
