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I. Kamiyama
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MINI 11 - Tobacco Control and Prevention (ID 108)
- Event: WCLC 2015
- Type: Mini Oral
- Track: Prevention and Tobacco Control
- Presentations: 1
- Moderators:S.M. Janes, E. Stone, K.M. Cummings
- Coordinates: 9/07/2015, 16:45 - 18:15, 601+603
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MINI11.07 - The Relationship between Smoking Status and Prognostic Factors after Surgery in Lung Cancer Patients with Chronic Obstructive Pulmonary Disease (ID 1388)
17:10 - 17:15 | Author(s): I. Kamiyama
- Abstract
Background:
Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD), which frequently coexists with lung cancer. For non-small cell lung cancer (NSCLC) patients with COPD, the poor prognostic factors after curative surgery and their association with smoking status are unclear.
Methods:
We enrolled 858 patients who underwent curative surgical resection for pathological stage I or II NSCLC in our institute between January 2002 and December 2012. Of these patients, those with COPD, as determined by a fixed post-bronchodilator ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC) below 0.7, were evaluated (n = 302). Clinical and pathological characteristics of the patients were retrospectively analyzed using the Cox regression hazards model to determine those that serve as poor prognostic factors after surgery.
Results:
The mean follow-up time was 49.3 months (±30.8 months; range, 1 to 135 months). The five-year disease-free survival rate was 70.2%, and the overall survival rate was 81.5%. Of 302 COPD patients, 243 (80.5%) had a smoking habit, whereas 59 (19.5%) did not. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion, 143 patients (47.5%) were diagnosed with stage I COPD and 159 patients (52.6%) were diagnosed with stage II COPD. The presence of a smoking habit (p = 0.010, hazard ratio [HR] 3.340, 95% confidence interval [CI] 1.334-8.359), lymphatic permeation (p = 0.001, HR 2.352, 95% CI 1.450-3.814), pathological T2 or T3 disease (p = 0.005, HR 1.666, 95% CI 1.165-2.381), and a preoperative serum carcinoembryonic antigen (CEA) value > 0.5 ng/ml (p = 0.041, HR 1.637, 95% CI 1.021-2.625) were determined to be indicators of poor recurrence-free survival in multivariate analysis. For overall survival rates, a smoking habit (p = 0.048, HR 7.527, 95% CI 1.017-55.738), a preoperative serum CEA value > 0.5 ng/ml (p = 0.001, HR 2.782, 95% CI 1.495-5.175), a histology of squamous cell carcinoma (p = 0.014, HR 2.220, 95% CI 1.175-4.193), and pathological N1 disease (p = 0.031, HR 2.505, 95% CI 1.089-5.762) were determined to be poor prognostic indicators in multivariate analysis. The disease stage as determined by the GOLD criterion was associated with neither recurrence-free nor overall survival rates. With regard to smokers, the number of pack-years did not significantly influence prognosis.
Conclusion:
We identified poor prognostic indicators for resected NSCLC in COPD patients. It should be noted that COPD patients who did not smoke had a better prognosis after surgery than those who did. Neither the number of pack-years in smokers nor the stage of COPD was related to prognosis after surgery.
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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): I. Kamiyama
- 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.
