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N. Kawatani
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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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P1.05-006 - Clinicopathological Features of Small-Sized Peripheral Squamous Cell Lung Cancer (ID 9203)
09:30 - 09:30 | Author(s): N. Kawatani
- Abstract
Background:
Recent advances in imaging technology have enhanced the detection rate of small-sized peripheral lung cancers. While squamous cell carcinoma (SCC) had previously been regarded as a representative histological type of centrally-located lung cancer, recent studies have reported an increase in peripheral SCC. In order to reveal the malignancy of such peripheral lung cancer, we retrospectively compared the clinicopathological features of small-sized peripheral SCC with that of adenocarcinoma (ADC) in surgically resected cases.
Method:
We retrospectively analyzed lung cancer patients who underwent radical surgical resections at Gunma University Hospital between July 2007 and October 2011. We included all 26 patients diagnosed with SCC and 214 patients diagnosed with ADC who had tumors smaller than 2 cm in pathological size.
Result:
Patients with SCC were significantly older than those with ADC. In SCC patients, 80% of patients were male and almost all patients were smoker, whereas in ADC patients, only half of patients were male and smoker. For pathological stage, only 62% of SCC were staged IA whereas 85% of ADC were staged IA. On the other hand, 16% of SCC were staged IIA to IIIA whereas only 8% of ADC were staged IIA to IIIA. SCC patients tended to have higher rate of lymph node metastasis compared to ADC patients, although there was no significant difference (16% vs. 8%; p = 0.25). The incidences of pleural invasion (31% vs. 12%; p < 0.01), vascular invasion (50% vs. 19%; p < 0.01), and lymphatic invasion (50% vs. 15%; p < 0.01) were significantly higher in SCC than in ADC. Rate of postoperative recurrence was higher in SCC patients compared to ADC patients (23% vs. 10%; p = 0.04), although there was no significant difference in pattern of recurrence. Five-year survival rate of SCC was significantly shorter compared to that of ADC (60% vs. 94%; p < 0.01).
Conclusion:
SCC patients had worse prognosis compared to ADC patients, although there was no difference in lymph node metastasis. Adjuvant chemotherapy should be considered in SCC patients in order to improve treatment outcome.
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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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P2.16-009 - Strategy for Oncologic Emergency in Thoracic Disease (ID 8953)
09:30 - 09:30 | Author(s): N. Kawatani
- Abstract
Background:
No large series of oncologic emergencies in thoracic surgery has been reported. Such patients are usually in critical condition and need immediate intervention of various types. Here, we present the surgical interventions that have occurred in our experience with oncologic emergencies.
Method:
We retrospectively analyzed 28 patients with oncologic emergencies who underwent surgical intervention at our hospital in 2002‒2016. The mean patient age was 76 years, and there were 19 (68%) males and 9 (32%) females. The primary disease was primary pulmonary carcinoma in 13 cases, including adenocarcinoma and squamous cell carcinoma in 4 and 6, respectively, other-organ carcinomas in 12, and mediastinal tumors in 3. Airway stenosis was the complaint in 19 (68%), including hemoptysis in 2, superior vena cava syndrome in 3 (11%), infectious diseases in 2 (7%), tumor bleeding in 2 (7%), and pneumothorax in 2 (7%).
Result:
The goal of surgery was a radical operation in 8 (29%), biopsy in 3 (11%), and palliative therapy in 17 (60%) patients. The surgical procedure was lobectomy in 4 patients, bronchoplasty in 4, wedge resection in 3, pneumonectomy in 1, tumor removal in 2, pleural decortication in 1, excisional biopsy in 4, airway intervention (stent or laser cauterization) in 11, and tracheostomy in 6. The mean hospital stay was 32±39 (range 3–155) days. The outcome was hospital death in 7 (25%) and discharge in 21 (75%). Of the discharges, 3 (11%) patients were transferred to another hospital, and 18 (64%) were sent home. The mean survival was 743±743 (range 3–3798) days. Of the 21 discharges, 7 (25%) patients are alive, including 4 (14%) who are cancer-free and 3 (11%) with cancer. As treatment, radical surgery was more effective than conservative therapy.
Conclusion:
The oncologic emergencies experienced in thoracic surgery included obstruction/stenosis, bleeding, infection, and rupture. Stenosis comprised the majority and was caused by tumor growth in the airway and compression and invasion by tumors. Good outcomes were expected in patients with slow-growing tumors who underwent laser cauterization or airway stent placement.
