Virtual Library
Start Your Search
Y. Horio
Author of
-
+
P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P1.03-044 - EUS-Guided Sampling of Mediastinal Lymph Nodes and Abdominal Lesions in Lung Cancer (ID 5147)
14:30 - 14:30 | Author(s): Y. Horio
- Abstract
Background:
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS–TBNA) was introduced to provide access to mediastinal and hilar lymph nodes. However, it is difficult to use EBUS to approach the aortopulmonary window and paraesophagaeal stations. Transesophageal endoscopic ultrasound (EUS) was introduced to provide access to this area. In addition, transgastroduodenal endoscopic ultrasound can evaluate abdominal lesions.
Methods:
Endoscopic ultrasound fine needle aspiration (EUS-FNA) was performed under conscious sedation with the administration of intravenous midazolam and pethidine hydrochloride. It was performed with a convex array echoendoscope connected to an ultrasound scanning system. Lymph nodes of paraesophageal, subcarinal, lower paratracheal, subaortic, and upper paratracheal regions were evaluated from esophagus. Left adrenal gland and right adrenal gland were evaluated from stomach and duodenum, respectively. Abdominal lesions were also evaluated from stomach and duodenum. After obtaining tissue via EUS-FNA, the tissue was reviewed immediately (rapid on-site cytopathological evaluation: ROSE) by a cytopathologist. Subsequent punctures in the same patient were not performed before confirming the results of ROSE so as to minimize the complications.
Results:
As to the lymph node level, the lower mediastinum and the aortopulmonary window are particularly important for detection by transesophageal EUS, whereas pretracheal and hilar lymph nodes are out of reach because of the interposition of air from the trachea and bronchi. EUS was chosen to assess the posterior mediastinum nodes (#5, 7, 8, or 9) but not the anterior ones. A final diagnosis was obtained by EUS-FNA in 76 patients. The lesions sampled were mediastinal lymph nodes (n=64; #5, 7, 8, or 9), abdominal lymph nodes (n=8), and adrenal gland (n=4).
Conclusion:
Repeat tumor biopsies from patients with acquired resistance were initially obtained through research efforts to ascertain mechanisms of resistance, but are now recommended to help select second-line therapies. However, such biopsies are associated with both risk and discomfort and may not always supply enough tumor tissue for genetic analyses. Although EUS–FNA does not provide access to pretracheal and hilar lymph nodes, EUS-FNA is an accurate, safe, and minimally invasive modality for evaluating mediastinal lymphadenopathy and abdominal lesions in patients suspected of having lung metastases.
-
+
P1.07 - Poster Session with Presenters Present (ID 459)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P1.07-007 - Clinical Outcomes of Patients with LS-SCLC Treated with Chemoradiotherapy. Can We Find Candidates for Salvage Surgery? (ID 5288)
14:30 - 14:30 | Author(s): Y. Horio
- Abstract
Background:
Although small cell lung cancer (SCLC) is generally considered a systemic disease even in patients with limited stage (LS). Selected recurrent LS-SCLC patients after chemoradiation treatment have been reported long survival with receiving salvage surgery. Purpose of this study was to find candidates for salvage surgery.
Methods:
We retrospectively reviewed the charts of 43 consecutive patients who were treated with chemoradiotherapy for LS-SCLC at our hospital from January 2011 to December 2015 to search for the patients with locoregional progression without mediastinal lymph node involvement.
Results:
Of the 43 patients, the median age was 69 (38-83), 91% were male and all of them had ECOG PS 0 or 1. Clinical stage: IIA (12%), IIIA (53%), IIIB (35%). 35 (81%) received hyperfractionated RT (45Gy/30fr/3w). Objective response rate was 95%. One patient died of pneumonia. The median survival time was 1584 days and the median progression free survival was 280 days. 33 (77%) demonstrated disease progression. The first progression site was distant (include pulmonary metastasis and malignant pleural effusion) in 17, locoregional in 11, lymph node metastasis out of the radiation field in 2 and both distant and locoregional in 3. In the locoregional progression patients, 6 developed mediastinal lymph node progression in their clinical courses. Finally, 5 in 33 progressive patients had locoregional progression without mediastinal lymph node progression, and were thought possible candidates for salvage surgery.
Conclusion:
Most of the patients experienced distant metastasis and/or mediastinal lymph node progression. About 15% of patients who presented with apparently localized disease at the primary pulmonary site after chemoradiation might become possible candidates for salvage surgery.
-
+
P3.01 - Poster Session with Presenters Present (ID 469)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P3.01-023 - Quality Assessment of Resampling Specimens in Primary Lung Cancers with Acquired Resistance to the Initial Therapy (ID 5543)
14:30 - 14:30 | Author(s): Y. Horio
- Abstract
Background:
Most patients treated against molecular targets eventually develop resistance even after an initial dramatic response. Although rebiopsy of tumors at progression provide information for next-line therapy, it is expected that the tumor tissues would be modified by the therapy.
Methods:
We retrospectively examined histologic features in the resampled specimens in lung cancer patients with resistance to the initial therapy. Furthermore, we also analyzed the differences of tumor cell contents and molecular testing performance according to each biopsy site.
Results:
A total of 315 resampled specimens were submitted to pathology department from 260 patients. Of 315 samples, 116 (37%) were obtained from the lung and 96 (30%) from pleural effusion, 42 (13%) from lymph node, 16 (5%) from liver, 12 (4%) from cerebrospinal fluid (CSF), 10 (3%) from pleura and pericardial effusion, 7 (2%) from bone and 6 (2%) from other biopsy sites. When we compared 48 paired lung tissues between initial and rebiopsies, rebiopsy specimens had significantly less extents of tumor cells and more fibrosis than those in initial biopsy, and these differences were statistically significant with digital quantitation. Resampled sites affect the tumor cell extents and those were high in the order of liver, subcutaneous tissue, lymph node and lung biopsy, whereas pleura and bone samples had a tendency to contain a less number of tumor cells. Molecular testing was performed in 272 samples (from 222 patients). Of 272 samples, 223 (82%) were successfully analyzed, whereas 49 samples were unsuitable for the testing due to low tumor-cell content or complete absence of tumor cells. Higher success rates for molecular testing were seen in the liver and lymph nodes and the value of bone was lowest. Resistant T790M mutations were also differently detected and the higher detection rates were seen in liver, pleura and pericardial effusions.
Conclusion:
Resampled specimens had different property in terms of tumor extents, which differed among the biopsy sites. For molecular testing using resampled specimens, the difference should be taken into account.
