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Kazunori Okabe
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P1.05 - Early Stage NSCLC (ID 691)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.05-003 - Impact of Coexisting Pulmonary Diseases on Oncological Outcomes of Patients with pStage I Non-Small Cell Lung Cancer (ID 7923)
09:30 - 09:30 | Author(s): Kazunori Okabe
- Abstract
Background:
Cigarette smoking is a well-known cause of interstitial lung diseases (ILDs), pulmonary emphysema, and lung cancer. Coexisting pulmonary diseases can affect outcomes of patients with early-stage lung cancer. The aim of this study was to analyze the influence of pulmonary diseases upon oncological outcomes of patients with smoking history who underwent surgery for pStage I non-small cell lung cancer (NSCLC).
Method:
Medical records of a total of 227 patients with smoking history (current/former) who underwent anatomical lung resections (200 lobectomies and 27 segmentectomies) for pStage I NSCLC between June 2009 and December 2014 were reviewed. Coexisting ILDs were evaluated on high-resolution computed-tomography (HRCT). The degree of pulmonary emphysema was determined using image analysis software, applying Goddard classification. The impact of clinicopathologic factors including pulmonary diseases on oncological outcome was evaluated.
Result:
Among the 227 patients, ILDs on HRCT were detected in 47 (20.7%) patients; of those, UIP pattern and non-UIP pattern were seen in 19 (8.4%) and 28 (12.3%) patients, respectively. The degree of pulmonary emphysema was classified into normal, mild and moderate, including 44 (19.4%), 146 (64.3%) and 37 (16.3%) patients, respectively. Pathological stages were IA in 131 patients and IB in 96. The 5-year overall survival (OS) and cancer-specific survival (CSS) were 81.2% and 88.2%, respectively. Univariate analysis showed that UIP-pattern on HRCT, moderate pulmonary emphysema, vascular invasion, visceral pleural invasion (VPI), and pStage IB were correlated with poor CSS. Cox proportional hazards models revealed that the presence of UIP-pattern and VPI were independent risk factors for poor CSS. During a median follow-up period of 42.7 months, recurrent diseases were seen in 41 (18.1%) patients. Multiple logistic regression analysis showed that the presence of UIP-pattern and VPI were significantly related with tumor recurrence.
Conclusion:
The coexistence of UIP-pattern ILD on HRCT was shown to negatively affect the oncological outcome of patients with smoking history who underwent surgery for pStage I NSCLC.
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P3.09 - Mesothelioma (ID 725)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Mesothelioma
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.09-005 - The Results of Trimodality Treatment Strategy for Malignant Pleural Mesothelioma (ID 8725)
09:30 - 09:30 | Presenting Author(s): Kazunori Okabe
- Abstract
Background:
Our standard treatment strategy for operable malignant pleural mesothelioma (MPM) is trimodality therapy with extrapleural pneumonectomy (EPP) followed by radiation and chemotherapy. Our experience to treat MPM is reported.
Method:
45 consecutive EPP for MPM which were performed from June 2006 to February 2017 in our hospital were reviewed. We have instituted a trimodality therapy protocol consisting of EPP, adjuvant 45-50.4 Gy hemithoracic radiation, and adjuvant CDDP plus PEM chemotherapy. 36 patients have been treated with this protocol. However, 9 patients were given induction chemotherapy, and referred to us. They were scheduled to undergo EPP and adjuvant radiation. Overall survival was calculated using Kaplan-Meier method.
Result:
Median age at EPP was 61 years old (44-74). Female was 11, and male was 34. Right side was 25, and left side was 20. Epithelioid was 30, biphasic was 10, sarcomatoid was 2, and special variants was 3. Median EPP time was 7 hours 30 minutes (5 h 52 m-12 h 2 m). No blood transfusion during EPP was 17 cases (38%). Mortality was one patient (2.2%) who died due to acute aggravation of interstitial pneumonia. Atrial fibrillation was the most common morbidity, and developed in 16 patients (36%). IMIG pathological stage was stage IV in 3, stage III in 26, stage II in 8, and stage Ib in 8. Adjuvant 45-50.4 Gy radiation was completed for 38 patients (83%). 10 patients (22%) could not undergo chemotherapy. 31 patients (69%) underwent trimodality therapy. Postoperative median follow-up period was 5 years and 10 months. Five year survival, two year survival, and median survival of all 45 patients (graph) were 32%, 44%, and 17.4 months, and those of 30 epithelioid patients were 41%, 54%, and 30.4 months.Figure 1
Conclusion:
This trimodality treatment strategy with EPP, radiation, and chemotherapy for MPM is feasible, and the prognosis has been greatly improved.
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P3.13 - Radiology/Staging/Screening (ID 729)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.13-013 - Association of Pleural Tags with Visceral Pleural Invasion of Peripheral Lung Cancer (ID 8716)
09:30 - 09:30 | Author(s): Kazunori Okabe
- Abstract
Background:
Visceral pleural invasion (VPI) is an important prognostic factor for patients with peripheral lung cancer, but its accurate preoperative evaluation with CT is difficult. Pleural tags, which are defined as one or more linear strands that extend from the tumor surface to the pleura, are sometimes seen in peripheral lung cancer that does not abut the pleura. However, studies evaluating the correlation of pleural tags with VPI are limited. The aim of this study was to evaluate the association of pleural tags with VPI of peripheral lung cancer, especially focusing on the type of pleural tags.
Method:
A total of 183 patients were retrospectively analyzed. They underwent pulmonary resection in our hospital between January 2009 and December 2015 for peripheral lung cancer ≦2 cm in solid tumor diameter and dose not abut the pleura. Forms of pleural tag were classified as follows; linear tag, linear tag with soft tissue component at the pleural end, and soft tissue cord-like tag. The relationships between VPI and clinical factors including the forms of pleural tag were analyzed using chi-square for independence tests, and then multivariate logistic regression models were applied.
Result:
Histologically, 23 (12.6%) patients were proven to have VPI. Overlap and multiple forms of pleural tags were frequently seen. Multivariate analysis revealed that tumors with linear tag with soft tissue component at the pleural end had significant association with VPI (p = 0.008). Sensitivity and specificity were 47.8% and 83.8%, respectively, in the prediction of VPI with this type of pleural tag. Presence of multiple linear tags also was associated with VPI (p = 0.036).
Conclusion:
Specific forms of pleural tag can predict VPI of peripheral lung cancer ≦2 cm in solid tumor diameter and dose not abut the pleura.
