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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): H. Date
- 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): H. Date
- 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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P3.01-026 - Clinical and Pathological Reappraisal of Primary Lung Carcer with Lymphoepithelioma-Like Carcinoma Morphology (ID 5978)
14:30 - 14:30 | Author(s): H. Date
- Abstract
Background:
Lymphoepithelioma-like carcinoma (LELC) is a rare form of lung cancer, usually encountered in Chinese patients. Similar to nasopharyngeal carcinoma which is strongly associated with Epstein-Barr virus (EBV) infection, LELC is defined as a poorly differentiated carcinoma reveals EBER-positive neoplastic cells and marked lymphocyte infiltrate by 2015 WHO classification; however, EBER-negative carcinomas showing LELC-like morphology are present and such cases might be classified as adenocarcinoma or squamous cell carcinoma based on the results of immunohistochemistry staining, such as p40 or TTF-1.
Methods:
We retrospectively reviewed the medical records of 5 LELC patients who underwent pulmonary resection in Kyoto University Hospital between 2005 and 2016. All five cases were primary lung tumors with histologic features of carcinoma characterized by poorly differentiated morphology admixed with heavy lymphocyte infiltrates which fit the criteria for the diagnosis of LELC as morphologic findings.
Results:
There were 4 men and 1 woman who ranged in age from 65 to 78 years, with a median age of 70. Three patients had lymph node metastasis and underwent surgical resection, followed by adjuvant chemotherapy.One patient died of second primary lung cancer (small cell carcinoma) but four patients were alive without tumor recurrence 4 months to 8 years and 11 months.Four patients (80%) were negative for EBV, suggesting no association between EBV and LELC in our institution study group.In immunohistochemistry staining, 4 cases were positive for p40 and one case was for TTF-1.patient Age Sex Smoking Location pStage Treatment EBER TTF-1 p40 Outcome 1 78 M Yes RUL T1aN0M0 Surg＋adjuvant rad negative negative positive 3y6m dead 2 68 M Yes LLL T1aN2M0 Surg＋adjuvant chemo negative negative positive 8y11m alive 3 71 F None LLL T3N1M0 Surg＋adjuvant chemo positive negative positive 6y2m alive 4 65 M Yes RUL T1bN1M0 Surg＋adjuvant chemo negative positive negative 5y11m alive 5 73 M Yes RUL T1aN0M0 Surg only negative negative positive 0y4m alive
Conclusion:
Our reexamination revealed that most LELCs were negative for EBER and were classified as squamous cell carcinoma by IHC study. This results might imply that EBER is not a requisite factor in the lung carcinoma with LELC-like morphology.
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P3.04 - Poster Session with Presenters Present (ID 474)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.04-011 - Salvage Surgery for Isolated Local Recurrence after Stereotactic Body Radiotherapy for Clinical Stage I Non-Small Cell Lung Cancer (ID 5633)
14:30 - 14:30 | Author(s): H. Date
- Abstract
Background:
Non-small cell lung cancer (NSCLC) recurs locally in about 10% of the patients treated with stereotactic body radiotherapy (SBRT). The purpose of this study was to investigate the safety and outcome of salvage lung resection in these cases.
Methods:
We retrospectively analyzed the clinical data on 13 patients who underwent salvage lung resection for isolated local recurrence after SBRT between 2007 and 2014. These 13 patients were diagnosed with clinical stage I NSCLC and received SBRT (48-60 Gy) between 1999 and 2013.
Results:
All were male and the average age was 76 years (64-86) at the time of surgery. The average duration between SBRT and the surgery was 20 months (10-105). Pathological diagnosis was adenocarcinoma in 7, squamous cell carcinoma in 4, and others in 2. Lobectomy was performed in 10 patients, segmentectomy in 2 and wedge resection in 1. Because the irradiated area was mainly confined to the peripheral lungs, central pulmonary structures were intact after irradiation. There was almost no pleural adhesion related to the irradiation.There was no perioperative mortality and 4 patients had morbidities. One patient had a conversion from VATS to thoracotomy due to bleeding and 3 patients had prolonged air leak postoperatively. The resected tumor diameter ranged from 12 to 50 mm with a median of 33 mm. Viable tumor cells were found in the specimens of all patients. Two patients were positive on mediastinal lymph nodes and were offered adjuvant chemotherapy. At a mean follow-up of 52 months (range, 13 to 103 months), the 3 and 5 year survival rates were 72% and 41%, respectively.
Conclusion:
Salvage surgery after SBRT was feasible and provided encouraging outcome.
