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H. Yashiro
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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): H. Yashiro
- 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.
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P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.03-007 - Salvage Surgery for Local Recurrence after Cryoablation for Non-Small Cell Lung Cancer: Importance of Diagnosis of Recurrence without Delay (ID 2598)
09:30 - 09:30 | Author(s): H. Yashiro
- Abstract
Background:
Non-surgical treatment for lung cancer, such as stereotactic body radiation therapy (SBRT), radiofrequency ablation (RFA), and percutaneous cryoablation have been performed as alternatives to surgery for lung cancer in patients with comorbidities, limited pulmonary reserve, or early diseases. Not many, but the significant portion of patients with such local modalities experience the local failures. The salvage surgery for such recurrence might have been attempted with considerable technical and oncological difficulties. Two cases with salvage resection for local failure after cryoablation are described.
Methods:
We reviewed two patients who had previously undergone cryoablation, in whom local recurrences were treated with salvage surgery. We evaluated perioperative parameters and histological findings, which indicated the local failure.
Results:
Case1: A woman was underwent cryoablation treatment for second primary T1aN0M0 lung adenocarcinoma in left lower lobe after 6 years of right lower lobectomy for lung adenocarcinoma. 4 years after the cryoablation, CT scan showed a tumor increasing in size in the area of treatment and local recurrence was suspected. Recurrence of adenocarcinoma was confirmed by CT guided biopsy. Segmentectomy of posterior segment of left lower lobe was performed. Operation time was 155minutes and blood loss was 72 ml. This patient is alive without any sign of recurrence after 8 years from surgery. Case2: A woman was underwent cryoablation for clinical stage T1aN0M0 lung adenocarcinoma in right lower lobe after 20 years of right upper lobectomy for lung cancer. 3 years after the cryoablation, CT scan showed a tumor growing in size in the area of treatment and local recurrence was suspected. Local recurrence of adenocarcinoma was proved by CT guided biopsy. Segmentectomy of superior segment of right lower lobe was performed. Operation time was 291minues and blood loss was 230 ml. This patient is alive without any sign of recurrence after 22 months from surgery. In both cases, salvage surgeries were performed without any difficulties. Pathological examinations showed viable cancer cells with necrotic tissue and fibrosis around which was consistent with the local recurrence after cryoablation.
Conclusion:
The salvage surgery for the local failures after non-surgical treatment modalities might be indicated in selected cases. The difficulties in diagnosis of local recurrence might cause the optimal timing of surgery.
