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T. Menju
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-022 - For down Staged Clinical N3 M0 Non-Small Cell Lung Cancer Patients Chemo-Radiotherapy Followed by Surgery Can Improve Survival (ID 5830)
14:30 - 14:30 | Author(s): T. Menju
- Abstract
Background:
Non-small cell lung cancer (NSCLC) patients with clinical (c-) N3 M0 are conventionally regarded as inoperable. However, the role of surgery for such patients clinically down staged after chemo-radiotherapy has not been ascertained. We retrospectively compared the outcome after chemo-radiotherapy plus surgery for down staged patients versus only conventional chemo-radiotherapy.
Methods:
Patients treated at our institute from 2000 to 2016 for primary NSCLC with c-N3M0 were identified. Amongst them, six patients received lung resection surgery after chemo-radiotherapy was given and clinical evidence of downstaging found. Fifty patients received only conventional chemo-radiotherapy during the same period. Survival was estimated using the Kaplan-Meier method.
Results:
All of the 6 patients receiving chemo-radiotherapy plus surgery, are recurrence-free survival. The survival time ranged from 5 to 91 months. The 5-year overall survival for the patients receiving surgery was 100% compared with 24% for the 50 patients who did not receive surgery (p= 0.04).
Conclusion:
Our results suggest that the combination of chemo-radiotherapy plus surgery may improve survival for preoperatively down staged c-N3M0 NSCLC patients. These results should be validated by large-scale, prospective, randomized trials.
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P2.02-036 - Double Plasty Operation; A Procedure with Pulmonary Arterioplasty and Bronchoplasty against Centrally Located Non-Small Cell Lung Cancer (ID 5683)
14:30 - 14:30 | Author(s): T. Menju
- Abstract
Background:
Against non-small cell lung cancer (NSCLC) centrally located and involving both artery and bronchus, resection with pulmonary arterioplasty and bronchialplasty are effective to avoid pneumonectomy and keep activity of daily life of patients. To elucidate the complications, prognosis, association with induction therapy and surgical technique of this complex operation with double plasty, we report the series in our institute.
Methods:
45 patients underwent bronchoplastic lobectomy due to NSCLC in our institute from January 2002 to December 2012 and 18 patients of these were received double plasty surgery (40.0%). As preoperatively, 4 received chemoradiotherapy (22.2%), 2 received chemotherapy (11.1%) and 1 received radiationtherapy (5.6%).
Results:
17 patients (94.4%) were added pedicled flap attachment on the bronchial anastomosis for reinforcement and prevention of contacting artery and bronchus. 10 of 16 patients (62.5%) who needed total pulmonary artery clamp were heparinized during clamping. No intraoperative and 30-day postoperative mortality was observed. Complications occurred in 7 patients (38.9%) and 1 patient died in 3 months after the surgery due to empyema which was induced by lung fistula developed with the influence of preoperative radiation therapy. Other 6 patients were all recovered from the complications without any sequel. There were no complications about bronchial anastomosis and the site of arterio-plasty. During observation period, 5 patients developed lung cancer recurrence and they all died. The overall 5-year survival rate was 66.7% although advanced stage.
Conclusion:
For locally advanced NSCLC, double plasty surgery can be valuable alternative to resect NSCLC completely and preserve lung function. Complications and overall survival rate are acceptable.
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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)
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P3.01-048 - Cigarette Smoking is Associated with Epithelio-Mesenchymal Transition in Human Adenocarcinoma (ID 5531)
14:30 - 14:30 | Author(s): T. Menju
- Abstract
Background:
Cigarette smoking (CS) is well known to cause lung cancer. In addition to the mechanisms of tumorigenesis of lung cancer with CS, a lot of evidences are currently accumulating that CS induces epithelio-mesenchymal transition (EMT) in tumor cells. The correlation of CS with the malignant properties of lung cancer remained elusive in clinical settings. Here we examined the clinical significance of CS with regard to EMT and malignant progression in human lung adenocarcinoma.
Methods:
Clinical samples were obtained from the 239 cases of resected lung adenocarcinoma which were consecutively operated from January 2001 to December 2007 in our institution. Pathological stage distribution of the cases by TNM classification (WHO, 7th edition) was below: 1A: 118, 1B: 71, 2A: 22, 2B: 4, 3A: 23, 3B: 1. Smoking history was taken from all the patients, then their smoking status were classified into 3 groups according to the Brinkman Index (Non;0, n=109: Light;1~400, n=29: Heavy;401~, n=101). The samples were immunostained against E-cadherin and Vimentin using tissue microarrays of resected specimens to assess the activation level of EMT. Then, we classified into 3 groups: the group ‘N’, E-cadherin(E+) and Vimentin(V-), “null” EMT activation; the group ‘F’, E-/V+, ‘full’ EMT; the group ‘P’, E-/V- or E+/V+, ‘partial’ EMT. The numbers of the group F/ P/ N were 38/ 93/ 108, respectively. Furthermore, DNA samples were extracted from frozen surgical samples and the mutations for the hot-spot exons of EGFR, K-ras, and p53 were detected by SSCP or direct sequencing methods. The differences of survival duration, pathological invasive factors, DNA mutations and EMT activation level were statistically analysed among smoking groups.
Results:
Significant difference was found in 5-year survival rate among 3 smoking groups: Non, 89.1%; Light, 89.5%; Heavy, 61.7%. Smoking status was significantly associated with EMT activation, DNA mutation status, local invasive factors, and lymph-node metastasis. In the tumors harboring either wild-type K-ras or wild-type p53, heavy smoking was associated with EMT activation (p<0.0001, p=0.0002, respectively), whereas no correlation with regard to EGFR staus.
Conclusion:
Smoking amounts had a significant association with EMT activation level and malignant progression of human adenocarcinoma. Heavy smoking was related with EMT activation of the tumors either with wild-type K-ras or p53.
