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F. Tanaka
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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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P1.08-064 - Surgery for Malignant Pulmonary Tumor Invading Proximal Left Main Pulmonary Artery (ID 4407)
14:30 - 14:30 | Author(s): F. Tanaka
- Abstract
Background:
Surgery for tumor invading proximal left main pulmonary artery (PA) may be technical challenge, and the current study conducted to assess its feasibility.
Methods:
Patients who received surgery for malignant pulmonary tumor invading left main PA, PA proximal to the first branch (usually A3), from 2011 through 2015 in our institute were retrospectively reviewed
Results:
Among 32 eligible patients (Table 1), 31 (97%) patients received complete resection with pneumonectomy (n=4) or lobectomy with PA-reconstruction (n=27). Pericardiotomy was necessary for proximal control of main PA in 12 patients, and combined bronchial sleeve resection and reconstruction were performed in 11 patients. Postoperative complications occurred in 7 patients, but a > grade 3 complication (ARDS) occurred in only one patient who received pneumonectomy. There was no operative or in-hospital death.Characteristics of Patients (n=32)
No. of Patients % Age, median (range) 70 years (47-85) Sex, Female / Male 6 / 26 19% / 81% Histology ・Primary lung cancer 30 94% ・Lung metastasis 2 6% Mode of lung resection ・Upper lobectomy 27 84% ・Pneumonectomy 4 13% ・Exploratory thoracotomy 1 3% Pericardiotomy 12 38% PA-resection 31 97% ・Circumferential resection 18 ・Partial resection 13 PA-reconstruction 27 84% ・Direct closure 25 ・Patch closure (with pericardium) 1 ・Vascular conduit (pulmonary vein) 1 Bronchial sleeve resection 11 34% Morbidity 7 22% ・Arrythmia 5 ・Prolonged air leak 2 ・ARDS 1 Mortality 0 0%
Conclusion:
Lobectomy with PA-resection and reconstruction was feasible to avoid pneumonectomy for tumor invading proximal left PA.
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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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P2.01-006 - Sensitive Detection of CTCs in Thoracic Malignant Tumors With "Universal" CTC-Chip (ID 5545)
14:30 - 14:30 | Author(s): F. Tanaka
- Abstract
Background:
Circulating tumor cells (CTCs) are tumor cells shed from primary tumor and circulate in the peripheral blood. CTCs, as a surrogate of distant metastasis, can be potentially useful in diagnosis and monitoring therapeutic effects in malignant tumors. Among a variety of systems for detection of CTCs, the “Cellsearch” is the only approved system for clinical use. However, EpCAM-negative tumor cells, such as those originating from non-epithelial cells and those undergoing epithelial-mesenchymal transition (EMT) cannot be captured with the “CellSearch” that is an EpCAM-based isolation system. Therefore, we have developed a novel polymeric microfluidic device (“Universal” CTC-chip) that can capture CTCs with or without EpCAM expression (AACR 2015). In the present study, we examined CTCs-detection performance of the CTC-chip in patients with thoracic malignant tumors (lung cancer [LC] as an “EpCAM-positive” tumor and malignant pleural mesothelioma [MPM] as an “EpCAM-negative” tumor) in comparison with that of the CellSearch.
Methods:
Peripheral blood sampled from each patient was divided and subjected to quantitative evaluation of CTCs with the CTC-chip as well as with the “CellSearch”. The CTC-chip, coated with an anti-EpCAM antibody, was used to capture CTCs in the blood samples (n=19) from lung cancer patients. To capture CTCs in the samples (n=11) from MPM patients, the CTC-chip was coated with an antibody against podoplanin that is expressed on the mesothelioma. After immuno-staining for cytokeratin and CD45 on the chip, a captured cell containing Hoechst-positive nucleus and cytokeratin-positive/ CD45-negative cytoplasm was judged as a CTC. The CTC-count for each sample was represented as the number per 7.5mL of the blood.
Results:
The median CTC-count detected with the CTC-chip in LC was 50 (range, 0-270), which was significantly higher than that (the median CTC-count, 0; range, 0-47) with the CellSearch (p<0.01). In the peripheral blood sampled from MPM patients, CTC was detected in only one patient using the CellSearch, but was detected in all 11 patients with the median CTC-count of 144 (range 0-470).
Conclusion:
The“universal” CTC-chip achieved higher performance in detection of CTCs of thoracic malignant tumors as compared with the CellSearch.
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P2.06 - Poster Session with Presenters Present (ID 467)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Scientific Co-Operation/Research Groups (Clinical Trials in Progress should be submitted in this category)
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.06-037 - A Feasibility Study of Concurrent Chemoradiation Followed by Surgery for Pathologically-Proven Clinical IIIA-N2 Non-Small Cell Lung Cancer (ID 4700)
14:30 - 14:30 | Author(s): F. Tanaka
- Abstract
Background:
The standard treatment for stage IIIA-N2 non-small cell lung cancer (NSCLC) is definitive chemoradiotherapy. However, the strategy for resectable IIIA-N2 disease remains controversial. This phase II multi-institutional trial (WJOG5308L) was designed to evaluate the feasibility for neoadjuvant chemoradiotherapy followed by surgery (tri-modality) in patients with pathologically-proven N2 NSCLC.
Methods:
Patients with resectable IIIA-N2 (pathologically proven N2) were eligible. Neoadjuvant chemotherapy consisted of weekly paclitaxel (40mg/m2) plus carboplatin (AUC 2) for 5 weeks. Concurrent radiotherapy (RT) was prescribed with 50 Gy in 25 fractions to the mediastinum and primary tumor. Patients underwent surgical resection, unless PD disease, followed by two courses of paclitaxel plus carboplatin consolidation chemotherapy. The primary endpoint was complete resection (R0) rate. Secondary endpoints were progression-free survival, overall survival, response rate, protocol completion rate and morbidity/mortality.
Results:
From December 2011 to November 2013, 40 patients were enrolled. The median follow-up time was 33.97 (7.2-46.3) months. The radiological responses to neoadjuvant chemoradiotherapy were as follows: no complete response, 23 (57.5%) partial response, 16 (40.0%) stable disease and one (2.5%) progression. 34 of 40 patients underwent surgery. Reasons for not receiving surgery were radiation pneumonitis (n=4), PD (n=1) and delay of protocol (n=1). Of 34 resections, twenty-eight were lobectomies, three were bilobectomies, two were pneumonectomies, and one was exploratory thoracotomy. Six patients underwent sleeve lobectomy, without any complication. Thirty-two patients achieved the primary endpoint, complete resection (R0) rate 80% (32/40). Pathological complete response (PCR) rate was 30.3%. Finally, 20 patients (50%) completed all planned tri-modality treatment. The 2-year progression-free and overall survival rates for all patients were 62.5% and 75.0%, respectively. The 2-year recurrence-free survival for patients who received R0 was 61.5%. Neutropenia was the main grade 3/4 morbidity and tolerable. 30-days mortality rate was 0 %. Two treat-related deaths (late bronchial fistula) occurred. Sites of first disease recurrences were mediastinal lymphnodes (n=9, 22.5%), lung (n=8, 20%), and brain (n=4, 10%).
Conclusion:
Tri-modality treatment, neoadjuvant chemoradiotherapy followed by surgery, for resectable IIIA-N2 NSCLC seems feasible and promising.
