Author of

• 16751

  +

  P1.05 - Poster Session with Presenters Present (ID 457)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Early Stage NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16793

    +

    P1.05-042 - Treatment Strategy of Limited Surgery for Early Lung Cancer (ID 4497)

    14:30 - 14:30  |  Author(s): K. Kojima
    • Abstract
    • Slides

    Background:
    The standard surgical procedure for operable lung cancer is lobectomy with lymph node dissection. However early lung cancer cases have been increasing in Japan and they have been able to be candidates for limited operation. We have predicted early lung cancer depending on image findings and performed a limited operation positively.
    
    Methods:
    The advisability of the limited operation is evaluated with computed tomography (=CT) and positron emission tomography (=PET) for the cases in which we have diagnosed a lung nodule as c-Stage IA by staging of lung cancer. We have judged surgical indication for limited operation when the tumor diameter in mediastinal window setting of high resolution CT is 5mm or less and SUVmax level in tumor portion is 1.5 or less even if it exceeds 5mm. We decided the orientation as follows: Wide wedge resection is performed for pure GGO (=ground glass opacity) based on expectation to be Adenocarcinoma in situ (=AIS). Segmentectomy with lymph node dissection is performed for mixed GGO to deal when it is difficult to distinguish whether that the lesion is AIS, Minimally Invasive Adenocarcinoma (=MIA) or Invasive Carcinoma. We examined whether each surgery method was appropriate compared with the postoperative pathological result.
    
    Results:
    Surgical treatment for lung cancer was performed to 453 cases in our hospital between Apr.2010 and Jun.2016. 115 cases were diagnosed as early cancer suspected in preoperation by the above criteria. Wide wedge resection was performed to 27 cases (31 lesions). 30 lesions were AIS and 1 lesion was MIA pathologically. We underwent left S9 segmentectomy with lymph node dissection in addition for 1 case of mucinous adenocarcinoma. Segmentectomy with lymph node dissection was performed to 58 cases (61 lesions). 26 lesions were AIS, 29 lesions were MIA, 5 lesions were invasive adenocarcinoma and 1 lesion was squamous cell carcinoma pathologically. In all cases of invasive adenocarcinoma and squamous cell carcinoma, both lymph node metastasis and lymphovascular invasion was negative, so we did not perform completion lobectomy in addition. We performed lobectomy to 23 cases in spite of our expectation as early cancer due to a lesion of the middle lobe, a lesion near pulmonary hilum or the request of the patients and pathological results were 7 AIS, 7 MIA and 9 invasive adenocarcinoma with no lymphovascular invasion and no lymph node metastasis.
    
    Conclusion:
    We can operate for the appropriate extent of resection for early lung cancer by making full use of image findings.
    
    

    Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.