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T. Inoue
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-008 - Impact of Perioperative Redox Balance on Long-Term Outcome in Patients Undergoing Lung Resection (ID 3954)
14:30 - 14:30 | Author(s): T. Inoue
- Abstract
Background:
Surgical stress provokes a cytokine storm and systemic inflammatory response syndrome, and can also affect redox balance during the postoperative course. However, whether inflammatory status, especially redox balance, during the perioperative period has effects on long-term outcome following surgery for lung cancer remains unclear. The aim of this study was to determine whether redox balance during the perioperative period is associated with long-term survival of patients after undergoing lung resection.
Methods:
Consecutive patients who underwent an anatomical lung resection greater than a segmentectomy for non-small cell lung cancer from January to June 2013 at our institution were investigated. The Ethical Committee of Dokkyo Medical University Hospital approved this study (#24043) and all participating patients provided informed consent. Serum was collected during the operation, and on post-operative day (POD) 3 and 7, and the levels of reactive oxygen metabolites (d-ROM) and biological antioxidant potential (BAP) were measured using FREE carpe diem (Wismerll). We analyzed overall survival, relapse, and cause of death.
Results:
Twenty-two patients (males 18, females; 69±7 years old) were enrolled, of whom 12 underwent open surgery and 6 VATS. Histology findings showed 12 adenocarcinomas, 6 squamous cell carcinomas, and 4 others. Comorbidities in the patients were chronic obstructive pulmonary disease in 8 and idiopathic pulmonary fibrosis in 5. d-ROM values on POD 3 and 7 were significantly increased as compared to those obtained during the operation (perioperative 288±65, POD 3 439±49, POD 7 479±49; p<0.001), whereas BAP did not change after surgery. Overall survival was 71.4% after 3 years. A receiver operating characteristic curve revealed a dROM cut-off value of 327 during the operation. Patients with a dROM value of 327 or less showed significantly superior 3-year survival as compared to those with a greater value (87.5% vs. 20.0%, p<0.001).
Conclusion:
Surgical stress caused an increase in dROM during the postoperative course. The dROM value obtained during the operation was correlated with long-term survival of patients after undergoing resection for lung cancer.
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P2.01 - Poster Session with Presenters Present (ID 461)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.01-080 - Mitosis Count of Lung Adenocarcinomas: Correlation between the Phosphorylated Histone 3, Number of Cancer Cells, Nuclear Grade, and Prognosis (ID 5661)
14:30 - 14:30 | Author(s): T. Inoue
- Abstract
Background:
Nuclear grading can prognostically estimate inter-observer reproducibility in pulmonary adenocarcinoma (Nakazato Y. et al, Cancer, 2010 and JTO, 2013). However, no correlation has been shown between pathologic prognostic marker, number of cancer cells, and survival in pulmonary adenocarcinoma cases. Immunohistochemistry for phosphorylated histone 3 (pHH3), which is present during early prophase, is a reliable mitosis-specific marker. We evaluated the correlation between pHH3-stained mitotic figures (PHMFs) and clinical outcome, comparing the results with those of PHMFs, Ki-67 labeling index, and number of cancer cells.
Methods:
Primary tumors were obtained from 104 patients with pulmonary adenocarcinomas (≤2 cm maximum dimension) who were treated surgically between January 2006 and December 2010 at Dokkyo Medical University Hospital. Specimens were stained with hematoxylin and eosin and pHH3 and anti-Ki-67 antibodies. Cells were enumerated with a NanoZoomer[®] Digital Pathology. Results were evaluated using receiver operating characteristic (ROC) curve analysis, the Kaplan–Meier method and Cox proportional hazards regression.
Results:
Cases judged negative by nuclear grading had significantly improved prognoses compared with positive cases (mean overall survival, 8.923 vs. 7.884 years; p=0.03). ROC curve analysis showed a cut-off of 400/10 hpf (area under the curve = 0.743; 95% CI = 0.594-0.891). Cancercell index, defined as the number of cancer cells within 10 hpf, of ≥400 tended to be positive, and of <400 tended to be negative. PHMF/cancercell index of ≥0.01 tended to be positive, and of <0.01 tended to be negative. PHMF/cancercell index (HR, 6.022), cancercell index (HR, 6.399), and lymphatic invasion (HR, 5.308) were correlated with prognosis (p<0.02). The number of cancer cells was correlated with Noguchi’s classification and WHO pathologic type (figure).Figure 1
Conclusion:
PHMF/cancer cell index is useful for prognostic evaluation of pulmonary adenocarcinoma. PHMF/cancercell index, cancercell index, and lymphatic invasion are strongly correlated with prognosis. The number of cancer cells correlates with Noguchi’s classification and WHO pathologic types.
