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Kazuhiro Ito
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-067 - Treatment of the Patients with Oncological Emergencies with Massive Pleural Effusion at the First Hospital Visit (ID 9108)
09:00 - 09:00 | Presenting Author(s): Kazuhiro Ito
- Abstract
Background:
Massive pleural effusion may cause the oncological emergencies in the patients with advanced lung cancer. We describe here the treatment experience of patients with the massive pleural effusion at the first visit.
Method:
Three patients had massive pleural effusion at the first visit from April 2016 to March 2017. We report these 3 patients treated with carboplatin, pemetrexed, and/or bevacizumab.
Result:
All of 3 patients urgently received the continuous chest tube drainage for several days (Table 1). Pleural effusion was examined for cytology. Patient A received pleurodesis therapy because of negative fluid cytology, while she was examined by CT guided needle biopsy. Patient B and C revealed malignant adenocarcinoma cytology in pleural effusion. Both of two received additional biopsy for EGFR-mutation and ALK-translocation. Patient A waited the result of the pathology of adenocarcinoma, EGFR-mutation of negative, and ALK-translocation of negative for 24 days. She received the chemotherapy of carboplatin and pemetrexed with pregressive disease and died of locally advanced lung cancer after 1 course of chemotherapy followed 20 days best supportive care. Patient B and C quickly began the first line chemotherapy of carboplatin, pemetrexed, and bevacizumab without waiting the result of EGFR-mutation and ALK-translocation. Patient B received the six-course of chemotherapy with partial remission, followed the one course of the maintenance chemotherapy of pemetrexed and bevacizumab, however, he died of brain metastasis 183 days after the first chemotherapy. Patient C received the six courses of chemotherapy, followed pemetrexed and bevacizumab maintenance therapy, and is living with partial remission more than 130 days.Table 1
Age Sex Pleural effusion cytology Additional pathology EGFR-mutation Period to the first chemotherapy 1st line chemotherapy Prognosis Patient A 77 F Class I Dissemination, adenocarcinoma wild 25 days Carboplation, Pemetrexed Dead, 58 days, Locally advancement Patient B 60 M Class IV Lung, adenocarcinoma wild 8 days Carboplatin, Pemetrexed, Bevaxizumab Dead, 183 days Brain metastasis Patient C 69 F Class IV Dissemination, Adenocarcinoma L858R 4 days Carboplatin, Pemetrexed, Bevaxizumab Alive, 130 days, PR
Conclusion:
Carboplatin, pemetrexed and bevcizumab treatment was well-tolerable in the patients with the oncological emergencies of massive pleural effusion. We should start the first line treatment as soon as possible. Two weeks of waiting period are so long for the patients with advanced lung cancer.
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P2.16 - Surgery (ID 717)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.16-008 - Collapsed Lung Index Ten Minutes after Thoracotomy and Pre-Operative Pulmonary Function Tests (ID 8932)
09:30 - 09:30 | Author(s): Kazuhiro Ito
- Abstract
Background:
The lung is still pneumatized and we cannot take a broad view of the chest cavity. As for surgeons, the prediction of lung prolapse is valuable for surgical manipulations. We estimated the degree of the collapsed lung ten minutes after thoracotomy (collapsed lung index; CLI). We also evaluated the relationship between CLI and pre-operative pulmonary function test.
Method:
From December 2016 to June 2017, we included 38 patients undergoing video-assisted thoracoscopic surgery (VATS) without pleural adhesion. CLI was determined as the degree of collapse of the lung ten minutes after opening the first thoracic port. CLI definition was as follows; Grade 1: the distance between visceral pleura and chest wall was less than 1cm, Grade 2: the distance was less than 3cm, Grade 3: the distance was less than 5cm, Grade 4: the distance was more than 5 cm and the lung parenchyma was partially deflated, and Grade 5: the lung was completely collapsed. We also checked the relationship between CLI and pre-operative pulmonary function test of the patients.
Result:
The patients are 47 years old to 83 years old. They consist of 25 males and 13 females. The numbers of CLI Grade 1 were 0 cases, Grade 2 were 4 cases, Grade 3 were 18 cases, Grade 4 were 14 cases, and Grade 5 were 2 cases. VATS were easily undergone with broad surgical view Grade 4 and Grade 5. The 42% of the cases are included in CLI Grade 4 and Grade 5. The mean value of %VC was 102.6 %, FEV1.0G was 76.8 %, and FEV1.0% was 100.3 % in Grade 4 and Grade 5 patients. The preoperative pulmonary function tests were better in Grade 4 and 5 than the other Grades.
Conclusion:
We proposed CLI to estimate the surgical views at the beginning of VATS. The preoperative pulmonary function will predict the surgical field. We are waiting for some methods to deflate the lung in CLI Grade 1, 2, and 3 to Grade 4 or 5. The complete collapsed lung should make a good contribution for Single port VATS.
