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Kenji Kimura
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MA 16 - Mediastinal, Tracheal and Esophageal Tumor: Multimodality Approaches (ID 675)
- Event: WCLC 2017
- Type: Mini Oral
- Track: Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:K. Shibuya, Francoise Mornex
- Coordinates: 10/17/2017, 15:45 - 17:30, Room 313 + 314
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MA 16.08 - Surgery for Pleural Dissemination of Thymoma; A 20-Year Experience (ID 9191)
16:30 - 16:35 | Presenting Author(s): Kenji Kimura
- Abstract
- Presentation
Background:
Surgical management of pleural dissemination of thymoma has been recommended in some reports, while reports on the long- term results of pleural dissemination resection are few. The aim of this study was to assess mid- and long- term results of surgical resection of pleural dissemination of thymoma.
Method:
We retrospectively analyzed data from patients with synchronous or metachronous pleural dissemination and primary thymoma who underwent surgical resection between 1996 and 2016 in our hospital.
Result:
During the study period, 38 patients underwent resection of pleural dissemination of thymoma. The synchronous group consisted of 21 patients with a median age of 50.2 years (range: 28—75 years) at the time of resection. The metachronous group consisted of 17 patients with a median age of 46.7 years (range: 30—65 years) at the time of resection of pleural dissemination. The median follow-up was 72.7 months (range: 3—248 months). In the synchronous group, 19 patients were in stage IVa and 2 patients were in stage IVb. The histological type of thymoma was type B1 in 3 patients, type B2 in 9 patients, typeB3 in 9 patients. In the metachronous group, Masaoka stage of the primary thymoma was as follows; 3 patients were in stage I, 5 patients were in stage II, 7 patients were in stage III and 2 patients were in stage IVb. The histological types of the resected dissemination nodule were type AB in 1 patient, type B1 in 1 patient, type B2 in 5 patients, and typeB3 in 10 patients. A macroscopic complete resection of pleural dissemination was achieved in 30 patients (79%) of all the patients. No perioperative deaths occured. Postoperative complications occurred in 5 patients (13.2%). During the observation period, 5 patients died (relation to the tumor in 4) in the synchronous group and 1 patient died (unrelated to the tumor) in the metachronous group. The 5- and 10-year overall survival rates of all the patients were 87.6% and 69.2%, respectively. Of all the patients, 14 received repeated resection of the pleural disseminated nodule. The 5- and 10-year overall survival rates from the first resection of pleural dissemination were 76.6% and 46.0% in the non-repeat resection group and 100% and 88.9% in the repeat resection group, respectively.
Conclusion:
Surgery for pleural dissemination of thymoma was safely performed and provides favorable prognosis. Repeat resection for pleural dissemination could be effective in achieving a prolonged survival.
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P1.17 - Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies (ID 703)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.17-002 - Clinicopathological Significance of Epithelial Mesenchymal Transition in Thymic Cancer (ID 8019)
09:30 - 09:30 | Author(s): Kenji Kimura
- Abstract
Background:
The epithelial to mesenchymal transition (EMT) is a fundamental biological process during which epithelial cells change to a mesenchymal phenotype which has a profound impact on cancer progression. It has been proposed that increased expressions of EMT markers, loss of epithelial markers such as E-cadherin, and altered expressions of mesenchymal markers such as N-cadherin are called as cadherin switching and associated with poor prognosis in cancer case. We analyzed the expression of E-cadherin and N-cadherin in thymic cancer to determine the relationship to clinicopthological factors and prognosis.
Method:
We collected the data of 31 patients with thymic cancer from our institution between 2000 and 2014. Immunohistochemistry was used to examine the expression of EMT markers, E-cadherin and N-cadherin in tumor specimens. We evaluated the correlation between EMT and prognosis in patients with thymic cancer. We also compared expressions of the cadherins in tumor specimens obtained both before and after preoperative chemoradiotherapy or chemotherapy from 14 patients with thymic cancer who underwent preoperative biopsy in our hospital.
Result:
Eighteen patients underwent preoperative treatment. The resection was extended to the surrounding organs in addition to thymectomy including thymic tumor and anterior mediastinal lymphadenectomy. Twenty-six patients had a R0 resection. Pathological findings revealed that one patient had Masaoka stage I disease, one had II, 20 had III, one had IVa, and 8 had IVb. The histological diagnosis was squamous cell carcinoma in 24, undifferentiated carcinoma in 4, and others in 3 patients. Immunohistochemically, decreased expression of E-cadherin or upregulation of N-cadherin was detected in surgically resected specimens in 15 patients whose tumor was classified as EMT marker-positive. According to a clinicopathological comparison of these groups, EMT status was not related to preoperative therapy, Masaoka staging, or histology. The 5-year survival rate for all patients was 86 %, 63 % for EMT marker-positive, and 100 % for EMT marker-negative. The survival rate of patients with EMT marker-positive tumors was significantly lower than that of those with EMT marker-negative tumors. Decreased expression of E-cadherin or upregulation of N-cadheirn was detected in surgically resected specimens after preopetative treatment compared with biopsy specimens obtained before treatment in 10 of 14 patients.
Conclusion:
EMT marker expression such as cadherin switching was detected in thymic cancer tumor and was more often detected after preoperative treatment, indicating that EMT may affect the degree of malignant potential in thymic cancer and make them insensitive to treatment.
