Virtual Library
Start Your Search
R. Kamohara
Author of
-
+
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)
-
+
P1.08-084 - Treatment for Elderly Patients with Clinical Stage I Non-Small Cell Lung Cancer; Surgery or Stereotactic Body Radiotherapy? (ID 3906)
14:30 - 14:30 | Author(s): R. Kamohara
- Abstract
Background:
The number of elderly lung cancer patients requiring surgery has been increasing due to the aging society and less invasive perioperative procedures. Stereotactic body radiotherapy (SBRT) is one of the effective treatments for early stage non-small cell lung cancer (NSCLC). The aim of this retrospective study was to compare the outcome of pulmonary resection to SABR for elderly clinical stage I NSCLC in our hospital.
Methods:
Over 80-year-old patients with clinical stage I NSCLC between August 2008 and December 2014 were treated either surgery or SBRT at Nagasaki university hospital. Propensity score matching (PSM) was performed to reduce selection bias in various clinicopathological factors including age, gender, tumor size, carcinoembryonic antigen (CEA), Charlson comorbidity index (CCI), Glasgow prognostic scale (GPS) and forced expiratory volume in one second (FEV1.0) were compared between surgery and SBRT.
Results:
Pulmonary resection was performed in 57 cases, SABR in 41 cases. In surgery group, operations included 34 lobectomies, 23 limited resection (segmentectomy and wedge resections). Systemic lymph node dissection was 16 and limited dissection was 41 cases. In SABR group, 17 cases (41.5%) were not proven in histology. 27 cases were given 48 Gy by 4 fractions, 14 were 60 Gy by 10 fractions, respectively. No treatment deaths were observed. Before PSM, the 5 year overall survival (OS) in surgery (68.3%) was significantly better than that in SBRT (47.4%, p=0.02). the 5 year disease specific survival (DSS) (94.1%, 78.2%, p=0.17, respectively) was not significant. Similar characteristics were identified in age (82 years), gender, tumor size (2.2 cm), CEA (3.6 ng/ml), CCI (1), GPS (0) and FEV1.0 (1.7 Litter) after PSM. The difference in 5 year OS became insignificant between the matched pairs (57.0%, 49.1%, p=0.56, respectively). 5 year DSS was not significant (87.1%, 70.2%, respectively). Both treatments for elderly clinical stage I NSCLC were acceptable though unknown histology and precise lymph node status still existed as important bias.
Conclusion:
Surgery for early stage NSCLC is a safe and feasible treatment. SABR could be effective and a good option for early stage NSCLC.
-
+
P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P2.02-038 - Surgical Outcome of Stage III A-cN2/pN2 Non-Small Cell Lung Cancer (ID 5834)
14:30 - 14:30 | Author(s): R. Kamohara
- Abstract
Background:
Treatment for patients with confirmed mediastinal lymph node involvement(cN2/IIIA) is still a controversial issue. In this study, we evaluated the effect of surgical outcome in patients with clinical(c-) stage IIIA-N2 non-small cell lung cancer (NSCLC) pathologically proven N2(cN2/pN2) before surgery.
Methods:
The subjects selected for analysis were 63 patients with Stage IIIA-cN2/pN2 NSCLC who underwent surgical complete pulmonary resection among 1340 cases receiving surgical resection for NSCLC at Nagasaki University between January 2000 and July 2013. Of these 63 cases, 32 patients pathologically proven N2-positive stage III NSCLC underwent induction therapy. As for the induction therapy, 21 cases had chemotherapy, and 11 cases had induction chemoradiotherapy (Cisplatin plus oral S-1 and concurrent 40 Gy radiation in 10 cases, Cisplatin, Vinorelbine, and Bevacizumab plus 60Gy radiation in 1 case).
Results:
In all 63 cases, 5-year overall survival (OS) was 32.3%. On univariate analysis, patholocial T factor (pT1-2), upper lobe origin, single-station pathological N2, negative subcarinal node status, and extent of N2 metastasis (localized N2 metastasis) were favorable predictive factors in OS. On multivariate analysis, identified adjuvant chemotherapy was the only independent predictors of survival.In the cases of induction therapy, partial response (PR) was observed in 20 patients (63%). Pathological down staging of N2 disease (from pN2 to pN0-1) was confirmed in 12 cases (37%). OS in this cases was 33.5%. In 10 patients with cisplatin plus oral S-1 and concurrent radiation, there were 4 patients (40%) had a down staging of disease with complete lymph node response. In these patients 3 cases are alive without recurrence during 12-32 months follow up.
Conclusion:
Induction therapy containing cisplatin plus oral S-1 and concurrent radiation seems be feasible and had good response rate. At present, although no improvement in survival was shown for the statistical analysis with induction chemoradiotherapy followed by surgery in cN2/pN2 NSCLC because the number of cases was low, we come to expect improving outcomes in the future.
