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A. Mogi
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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): A. Mogi
- 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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P1.16 - Surgery (ID 702)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.16-007 - Mobile Computed Tomography in Video-Assisted Thoracoscopic Surgery for Ground-Glass Opacity Lung Nodules (ID 8533)
09:30 - 09:30 | Author(s): A. Mogi
- Abstract
Background:
In the thoracic surgery for non-palpable and invisible ground-glass opacity (GGO) lung nodules , various methods have been reported, such as needle sticking or infusion of roentgen non-permeable substances around the tumor under computed tomography (CT) guidance. However, there are serious problems such as air embolism and/or tumor dissemination into the thoracic cavity. Mobile computed tomography, O-arm Surgical Imaging System (Medtronic), can provide an image intraoperatively. In this study, we evaluated the usefulness of mobile computed tomography in thoracic surgery for the GGO lung nodules.
Method:
From December 2016 to May 2017, 3 patients with ground-glass opacity lung nodules were evaluated under video assisted thoracoscopic surgery using O-arm system. Before surgery, the patient was placed in lateral decubitus position in the CT room, and the skin directly above the tumor was marked with a skin marker. In the operation room, a port was made on the marked position, and a Naruke's thoraco cotton dyed with indigo carmine was introduced into the port to mark the visceral pleura just above the lesion. Then, the tumor-side lung was deflated, and the marked visceral pleura was grasped with non-traumatic forceps. Intraoperative CT imaging was reconstructed with O-arm, and the GGO lesion was comfirmed and resected under the guidance of positional relationship between the forceps and the tumor.
Result:
In all 3 patients, the tumor could be seen intraoperatively with computed tomography using the O-arm system, and resected properly. No complications were experienced in this study on the use of the O-arm system.
Conclusion:
The O-arm system could be a new strategy for the surgical treatment of non-palpable lung lesions.
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P2.02 - Biology/Pathology (ID 616)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.02-026 - Impact of PD-L1 Expression on 18F-FDG-PET in Pulmonary Squamous Cell Carcinoma (ID 7903)
09:30 - 09:30 | Author(s): A. Mogi
- Abstract
Background:
2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with positron emission tomography (18F-FDG-PET) is clinically useful for the evaluation of cancer. The accumulation of 18F-FDG within tumor cells is implicated in the expression of glucose transporter 1 (GLUT1) and hypoxic inducible factor-1α (HIF-1α). Although anti-programmed death-1 (PD-1) antibody therapy is approved for non-small cell lung cancer (NSCLC), the predictive biomarkers remain unknown. It was recently reported that the expression of programmed death ligand 1 (PD-L1) was positively correlated with the expression of GLUT1 and HIF-1α. Based on these backgrounds, we investigated the relationship between the tumor immunity including PD-L1 expression and the degree of 18F-FDG uptake in surgically resected pulmonary squamous cell carcinoma (SQC).
Method:
One hundred and sixty-seven patients (153 men, 14 women) with SQC who underwent 18F-FDG PET were included in this study. Tumor sections were stained by immunohistochemistry for GLUT1, HIF-1α, PD-L1, CD4, CD8, and Foxp3. Relationships of clinicopathological and molecular biological features to the degree of FDG uptake and survival were analyzed.
Result:
The SUVmax of 18F-FDG was significantly correlated with the expression of PD-L1 (p=0.0224) and GLUT1 (p=0.0075). The PD-L1 expression was significantly correlated either with GLUT1 (p=0.0059), HIF-1α (p<0.0001) or CD8 (p=0.0006). Other pairs exhibiting significant correlation are as follows: GLUT1 and HIF-1α (p=0.0072), HIF1α and CD8 (p=0.0072), CD8 and Foxp3 (p<0.0001). Univariate analysis demonstrated that advanced stage (p=0.0027), elevated SUVmax (p=0.0233), and elevated PD-L1 expression (p=0.0157) were associated with unfavorable overall survival (OS). Multivariate analysis also revealed that advanced stage (p=0.0445), elevated SUVmax (p=0.0382), and elevated PD-L1 expression (p=0.0173) were independent prognostic factors predicting unfavorable OS.
Conclusion:
18F-FDG uptake was significantly correlated with the expression of PD-L1 and GLUT1 in SQC. 18F-FDG PET may reflect the immune response in the tumor microenvironment involved in the regulation of PD-L1 expression.
