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S. Oura



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    P1.03 - Chemotherapy/Targeted Therapy (ID 689)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Chemotherapy/Targeted Therapy
    • Presentations: 1
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      P1.03-033 - Long-Term Outcome of Histoculture Drug Response Assay Guided Adjuvant Chemotherapy in Patients with Non-Small Cell Lung Cancer (ID 9259)

      09:30 - 09:30  |  Author(s): S. Oura

      • Abstract

      Background:
      Histoculture Drug Response Assay (HDRA) is a representative in vitro drug response assay used for anticancer agents. Several papers reported that HDRA was useful to predict chemosensitivities in non-small cell lung cancer (NSCLC). However, it is unknown that whether HDRA truly predict clinical outcome and associate with other predictive markers, such as ERCC1 and class III beta-tubulin (TUBB3).

      Method:
      Between August 2007 to July 2009, 46 patients with non-small cell lung cancer who underwent surgical treatment were enrolled. HDRA technique was the same as we previously reported (JTCVS 133: 303-8, 2007). Chemosensitivities of cisplatin (CDDP), paclitaxel (PTX), docetaxel (DTX), and vinorelbine (VNR) were evaluated. Immunohistochemical staining for ERCC1 and TUBB3 were done using monoclonal antibody clone 8F1 and TUJ1. The H-score was adopted for the evaluation of ERCC1 and TUBB3 expression. Adjuvant therapy was selected for each patient based on HDRA within the standard treatment. Median follow up period was 117 months.

      Result:
      ERCC1 was positive in 38 specimens and negative 6 specimens. Inhibition rate for CDDP in HDRA was significantly lower (p=0.02) in ERCC1-positive specimens (41±16)% than in ERCC1-negative specimens (58±8%). TUBB3 was positive in 12 specimens and negative 32 specimens. Inhibition rate for VNR in HDRA was significantly higher (p=0.01) in TUBB3-positive specimens (38±17)% than in TUBB3-negative specimens (23±15%).However, inhibition rate for PTX and DTX were not significantly correlated with TUBB3 status (p=0.39, 0.94).Disease -free survival(DFS) in patients from IB to IIIA with HDRA guided therapy tended to be longer than those without HDRA (p=0.083). Overall survival (OS) in patients from IB to IIIA with HDRA guided therapy were not to be longer than those without HDRA (p=0.77).

      Conclusion:
      Tumors with low ERCC1 levels exhibited greater chemosensitivity to CDDP than tumors with high ERCC1 levels. Tumors with high TUBB3 levels exhibited greater chemosensitivity to VNR than tumors with low TUBB3 levels. HDRA-guided adjuvant chemotherapy may prolonged RFS, but not affect to OS.

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    P2.16 - Surgery (ID 717)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P2.16-010 - Removing the Chest Tube on the First Day after Surgery Does Not Contribute to the Early Discharge from the Hospital (ID 8962)

      09:30 - 09:30  |  Author(s): S. Oura

      • Abstract

      Background:
      Postoperative chest tube drainage is essential in pulmonary surgery. After chest tube removal, the patient can be discharged from the hospital promptly. Therefore, it should be a close relationship between hospital stay and drainage duration. Removing chest tube in the early postoperative period leads to reduction of pain and early discharge from the hospital. However, there are few reports about removal chest tube on the first day after surgery. In this study, we examined cases where chest tube was removed on the first day after surgery.

      Method:
      From January to December 2016, 48 patients with lung cancer underwent lobectomy in our institute. They were consisted of 35 males, 13 females, and median age was 72 (53-87) years old. Among them, chest tube was removed on the postoperative day (POD) 1 in 24 patients (Group 1) and on the POD2 in 24 patients (Group 2). Patients complicated of postoperative lung fistula and infection were excluded.

      Result:
      Patients were discharged from the hospital on 5.4 days after surgery in Group 1 and on 5.6 days in Group 2. There was no significant difference between them (p=0.48). The CRP values on POD1, 2, and 3 were 5.49±2.38, 12.0±4.71, and 11.6±6.12 mg/dl in Group 1, and 7.27±3.28, 15.5±6.31, 12.9±5.87 mg/dl in Group 2, respectively (p=0.03, p=0.03, p=0.46). In addition, the period until CRP peaked out was 2.5 days in Group 1, and 2.1 days in Group 2. Group 2 showed obviously short period until CRP peaked out (p=0.03).

      Conclusion:
      Removing the chest tube on the first day after surgery will not lead to an early hospital discharge, conversely it will prolong the inflammatory response such as CRP.

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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
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      P3.13-012 - Fast Fourier Transform Analysis for the Outline of Pulmonary Nodules on Computed Tomography Images (ID 8592)

      09:30 - 09:30  |  Author(s): S. Oura

      • Abstract

      Background:
      Primary lung cancers show more complicated outline on computed tomography (CT) images of the chest than metastatic lung tumors or benign inflammatory lung disease. This feature is proving to be useful for clarifying the diagnosis of pulmonary nodules. The degree of complexity of pulmonary nodules seen on chest CT images is usually described subjectively by such designations as spiculated, irregular, and so on. Up to now there have been no established methods for evaluating a tumor outline numerically. In this study, we applied fast Fourier transform (FFT) analysis to pulmonary nodules on CT images to evaluate variations in the outlines of primary versus metastatic lesions or benign inflammatory lesions.

      Method:
      Sequential cases of 72 histologically proven primary lung cancers (group PL), 54 metastatic lung tumors (group MT), and benign inflammatory nodule (group BN) were included in the study. The average ± SD diameters of tumors in groups PL, MT, and BN were 18.9±7.4 mm, 12.2±6.1 mm, and 18.0±5.3 mm, respectively. For the measurements, the outline of each tumor on chest CT images was described using polar coordinates. The data were converted to rectangular coordinates, yielding wave data of the tumor outline. The FFT was then used to analyze the wave data. The complexity index (Cxi) and high frequency percent (HF%) were determined for each tumor. The Cxi was defined as the sum of the amplitude of all harmonics over a fundamental frequency. The HF% was defined as the percent of the high frequency components against Cxi.

      Result:
      The Cxi was 10.3±6.7 mm, 3.2±2.4 mm, and 8.0±3.8 mm, in groups PL, MT, and BN, respectively. The Cxi was significantly smaller in group MT than group PL (p<0.0001) and group BN (p=0.0003). Cxi was significantly correlated with tumor diameter in each group. Discriminant analysis showed a significant difference (P<0.0001) in Cxi between groups PL and MT with regard to tumor diameter. “Cutoff=0.127*DT+2.23” provided the cutoff value that yielded the highest diagnostic accuracy for distinguishing primary lung cancers from metastatic lung tumors. Use of this cutoff line resulted in a sensitivity of 95.8%, specificity of 81.5%, and accuracy of 89.7%. The HF% was 1.82±2.23%, 3.78±3.93%, and 5.29±1.28, in groups PL, MT, and BN, respectively. The HF% was significantly (p<0.0001) smaller in group PL than group BN.

      Conclusion:
      Fast Fourier transform analysis of tumor outlines appears useful for distinguishing primary lung cancer from the other diseases.