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R. Shimizu



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    P2.05 - Poster Session with Presenters Present (ID 463)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Radiotherapy
    • Presentations: 1
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      P2.05-007 - Outcomes after Stereotactic Body Radiothrapy/Proton Beam Therapy or Wedge Resection for Stage I Non-Small-Cell Lung Cancer (ID 4409)

      14:30 - 14:30  |  Author(s): R. Shimizu

      • Abstract
      • Slides

      Background:
      Recently, excellent results of stereotactic body radiotherapy (SBRT), proton beam therapy (PBT) for stage I non-small-cell lung cancer (NSCLC) have been reported, however any phase III trial comparing SBRT and surgery have not been completed yet. The aim of this study is to compare outcomes between SBRT, PBT and wedge resection (WR) for patients with peripheral stage I NSCLC who intolerable for anatomical resection, and analyze prognostic factors in this population.

      Methods:
      We retrospectively compared overall survival (OS), local recurrence rate (LRR), relapse-free survival (RFS) and cause-specific survival (CSS) between WR (n=172) and SBRT / PBT (n=188) for pathologically proven clinical stage I NSCLC in our institute from 2002 to 2015. Patients underwent WR were all high risk patients who intolerable for anatomical resection and achieved complete resection without any adjuvant therapy. Of radiation group (RT: SBRT+PBT), 56% was medically inoperable, with 44% refusing surgery. SBRT; 60 Gy in 8 fractions, PBT; 60-80 GyE in 10-20 fractions was prescribed. Propensity score matching was used to adjust the confounding effects in estimating treatment hazard ratios. 59 WR patients and 59 radiotherapy (RT) patients (SBRT 27, PBT 32) were matched blinded to outcome (1:1 ratio). There are 70 men and 48 women, median age was 81, and median follow-up period was 39 months.

      Results:
      3, 5 - year overall survival (OS) of WR and RT was 84.5%, 70.8% vs 89.7%, 59.6% (p=0.802), respectively. 3-year LRR, RFS, CSS were 94.7% vs 95.9% (p=0.751), 87.5% vs 75.6% (p=0.151) and 91.2% vs 93.9% (p=0.875), respectively. Multivariate analysis of prognostic factors for OS demonstrated any factors including treatment modality were not significant.

      Conclusion:
      Our results suggest that the treatment outcome of SBRT / PBT was equivalent to that of WR, SBRT / PBT may be alternative treatment in stage I NSCLC high risk patients.

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    P3.04 - Poster Session with Presenters Present (ID 474)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P3.04-004 - The Risk Factor of the Thrombus Formation in Pulmonary Vein Stump after Left Upper Lobectomy for Lung Cancer (ID 5105)

      14:30 - 14:30  |  Author(s): R. Shimizu

      • Abstract
      • Slides

      Background:
      It has been known that thrombosis in the pulmonary vein (PV) stump after lobectomy could possibly be the cause of embolism of vital organs including cerebral infarction. Several studies have proved that left upper lobectomy is the risk factor of thrombus forming in the PV stump. The aim of this study was to clarify the risk factors of thrombus forming in the PV stump after left upper lobectomy for lung cancer.

      Methods:
      At our institute, 342 patients underwent left upper lobectomy for lung cancer from September 2002 to December 2013. Among them, 296 patients who received follow-up enhanced CT after surgery were retrospectively analyzed to see whether the thrombus in the left superior pulmonary vein (LSPV) stump would be detected. We analyzed the risk factors for thrombosis formation by uni-, and multivariate analysis.

      Results:
      Thrombus in the LSPV stump was formed in 21 patients (7.1%). Body Mass Index (BMI) of the thrombus forming group (median, 23.64; range 20.03 to 28.99) was significantly higher than the no-thrombus-forming group (median, 22.06; range 13.37 to 30.57; p=0.022).　Univariate analysis revealed that significant risk factors include high BMI (p=0.022), no history of malignant disease (p=0.045), history of ischemic heart disease (p=0.049), cut LSPV at peripheral branch (p=0.029), pN2 (p=0.005), pStage III or higher (p=0.007), and adjuvant chemotherapy (p=0.005). In multivariate analysis, only pStage III was the significant risk factor.

      Odds Ratio 95% Confidence Interval p Value
      BMI 1.170 0.992 - 1.379 0.061
      History of malignant disease 0.288 0.037 - 2.273 0.238
      History of ischemic heart disease 3.485 0.952 - 12.756 0.059
      Cut LSPV at peripheral branch 3.611 0.801 - 16.272 0.095
      pStage III or IV 3.830 1.394 - 10.524 0.009
      Table1. Multivariate Analysis of Clinicopathologic Factors

      Conclusion:
      Thromboses were formed frequently after left upper lobectomy for advanced lung cancer.

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