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K. Emoto
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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): K. Emoto
- 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.
