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S. Takahashi
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MINI 36 - Imaging and Diagnostic Workup (ID 163)
- Event: WCLC 2015
- Type: Mini Oral
- Track: Screening and Early Detection
- Presentations: 1
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MINI36.13 - Quantitative Computed Tomography as Predictor of Cardiopulmonary Complication after Lobectomy for Lung Cancer in COPD Patients (ID 1227)
19:40 - 19:45 | Author(s): S. Takahashi
- Abstract
- Presentation
Background:
In lung cancer resection, COPD is a risk factor for postoperative complications. There are few reports about postoperative complications that assume a pictorial emphysematous change an index. We examine a relationship of an emphysematous regional ratio in preoperative CT in patients with COPD who underwent lung cancer resection and cardiopulmonary complication.
Methods:
One hundred fifty-nine patients with COPD who underwent lobectomy for lung cancer in our hospital from 2002 to 2011 were retrospectively evaluated in this study. Preoperative factors, including proportion of emphysematous area measured by CT (percentage of low attenuation area: LAA%), and operative factors were analyzed. Cardiopulmonary complications include pyothorax, pneumonia, atelectasis, acute pulmonary injury, chest tube indwelling, O~2~ long supply and arrythmia.
Results:
Cardiopulmonary complications were observed among 61 patients (38%). Ages, FEV1.0%, LAA% and amounts of blood lost were significantly relevant to cardiopulmonary complications by univariate analysis. Multivariate analysis indicated that patient’s age and LAA% could be significant independent predictors. Table1.Complications incidence by LAA%
Table2. Operative factors in relation to cardiopulmonary complicationsLAA% N complications：n=61 no complications：n=98 p value ～1% 1～10% 10%～ 77 67 15 15(19.5%) 37(55.2%) 9(60.0%) 62(80.5%) 30(44.8%) 6(40.0%) <0.001 variables Odds ratio 95%Confidence Interval p value Age(>70 years) FEV1.0% GOLD PaO2 LAA%（1%～） blood lost（>150ml） 4.612 1.042 2.044 0.973 5.570 2.073 2.028-10.489 0.973-1.117 0.857-4.876 0.940-1.008 2.302-13.480 0.878-4.894 ＜0.001 0.242 0.107 0.128 ＜0.001 0.096
Conclusion:
LAA% is useful for predicting cardiopulmonary complications in patients with COPD undergoing lobectomy for lung cancer.In patients with COPD undergoing lobectomy for lung cancer, 70 years of age or older, the LAA% 1% or more of the cases, more careful intraoperative, and postoperative management are required.
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P3.06 - Poster Session/ Screening and Early Detection (ID 220)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.06-027 - Stage and Histology Specific Differences in Patterns of Recurrence in Early Stage and Locally Advanced Non-Small Cell Lung Cancer (ID 2437)
09:30 - 09:30 | Author(s): S. Takahashi
- Abstract
Background:
Various guidelines have proposed continuous surveillance for non-small cell lung cancer (NSCLC) after curative therapy. Yet the optimal postoperative surveillance strategy remains unclear.
Methods:
Patients who underwent complete resection for stage I-IIIA NSCLC were analyzed. Complete resection was defined as lobectomy and lobe-specific systematic nodal resection or more. We compared patterns of recurrence in patients with histology and early stage vs locally advanced NSCLC.
Results:
From 2002 to 2010, 745 patients were identified. 106 of 625 patients (17%) with stage I-II NSCLC and 74 of 120 patients (62%) with stage IIIA NSCLC developed recurrences. Local recurrences were significantly frequent in stage IIIA patients (45 [61%] vs 29 [27%] for stage I-II patients), whereas distant recurrences were about the same frequency in stage I-II and IIIA patients (91 [86%] vs 64 [86%]). Approximately 90% of recurrences had occurred within 3 years after surgery and recurrence rate within first year was significantly higher in stage IIIA patients (51 [69%] vs 52 [49%] for stage I-II patients; p=0.008). Squamous cell carcinoma (SqCC) patients had tendency to relapse earlier than non-SqCC patients (Figure 1). In particular, all recurrences in stage IIIA-SqCC patients had occurred within first 2 years . Although the risk of recurrence in stage IIIA patients was highest in the first 2 years, it remained consequential up to 6 years after surgery (Figure 2). Figure 1 Figure 2
Conclusion:
Stage IIIA NSCLC patients had significantly higher risk of recurrence and this risk was continued to 6 years after surgery. SqCC patients had tended to recur earlier. Surveillance strategies may need to account for stage- and histology-specific differences.
