Author of

• 17493

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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: 1
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17528

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    P2.02-035 - The Advantage of Induction Chemoradiotherapy in Bronchoplastic Procedure for Non Small Cell Lung Cancer Accompanied with Central Disease Region (ID 5565)

    14:30 - 14:30  |  Author(s): S. Ohtani
    • Abstract

    Background:
    A bronchial sleeve lobectomy is a widely accepted procedure for enabling the pulmonary parenchyma to be spared. Trimodality therapy is one of therapeutic options for locally advanced non-small-cell lung cancer (NSCLC), though the negative effect of chemotherapy or radiotherapy on tissue healing is a concern. This study aimed to compare the clinical outcomes of pulmonary resection with bronchoplasty with or without prior induction chemoradiotherapy (CRT) and to investigate the feasibility of induction CRT in bronchoplastic procedure.
    
    Methods:
    The medical records of NSCLC patients who underwent surgery with bronchoplasty at our institution between January 1999 and September 2014 were reviewed. We compared the clinical outcomes of bronchoplasty with or without induction CRT.
    
    Results:
    A total of 58 NSCLC patients were the subjects of this study. Among them, 38 patients underwent primary surgery with bronchoplasty and 20 patients underwent surgery with bronchoplasty after induction CRT. The median patient age was 64 years (range: 31–81 years). The histological subtype was adenocarcinoma in 18 patients, squamous cell carcinoma in 39, large cell carcinoma in one. Of the 58 patients, seven patients had stage IA disease, five had stage IB disease, 10 had stage IIA disease, six had stage IIB disease, 24 had stage IIIA, and six had stage IIIB. Regarding the postoperative complications, there are no significant differences between the primary surgery group and the induction CRT group (P = 0.47). For the entire population, the 5-year overall survival (OS) rate was 69.9 %, and the 2-year recurrence-free survival (RFS) rate was 64.2 %. Even though the clinical stage was significantly higher in the induction CRT group than in the primary surgery group (P = 0.0006), no significant differences in OS and RFS rate were observed between the two groups. Regarding the intraoperative procedures, patients in the primary surgery group had a significantly higher rate of additional bronchial resection because of positive bronchial margin for cancer cell than those in the induction CRT group (P = 0.023).
    
    Conclusion:
    In bronchoplasty, additional resection of airway after intraoperative histological examination should be avoided to prevent tumor cell dissemination. Our experience suggests the possible advantage of induction CRT to ensure the surgical margin and indicates that surgery with bronchoplasty after induction CRT is a feasible procedure.