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Y.D. Kim
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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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P1.16-001 - Characteristics of Resected Lung Cancer in Patients Aged under 60: A Single–Center Experience (ID 8881)
09:30 - 09:30 | Author(s): Y.D. Kim
- Abstract
Background:
The proportion of younger patients with lung cancer is smaller than the older. But, as with older patients, the number is on the rise and clinical features of younger patients might be different compared to older patients. So we investigated the characteristics of younger patients with resected lung cancer through reviewing medical records.
Method:
From January 2010 to December 2014, 424 patients underwent operation for lung cancer at Pusan national university hospital. Mean age was 63.4±9.8 years old. Of them, 135 were under 60 years old (younger group). Medical records including demographic factors, histological type, surgical factors and outcomes, disease free survival rate (DFS) and overall survival rate (OS) were reviewed retrospectively.
Result:
In younger group, mean age was 52.2±7.6 years old and proportion of female was significantly higher (p value=0.00). Co-morbidity and other combined malignancies were smaller (respectively, p value = 0.00 and 0.007) and proportion of adenocarcinoma were higher than older group (p value = 0.03). Mean operative time was shorter than older group (4.57 versus 4.90 hours, p value= 0.03). There was no significant difference in other factors (postoperative complications, surgical approach, FEV1, hospitalization, and etc.). Mean follow up duration was 34.0±17.7 months, and 3 year DFS and 3 year OS of younger group in stage IA was 97.9% (versus 94.0% in older patients, p value = 0.009) and 96.4% (versus 93.3% in older patients, p value = 0.07). In other stage, there was no significant difference of DFS and OS.
Conclusion:
This study shows that there were significantly different characteristics between younger and older patients group including DFS in pathologic stage IA, sex, and proportion of histological type, and suggests that development and application of more adequate modalities for early diagnosis and treatment in younger patients is needed.
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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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P2.16-011 - Unsuspectedly Detected Isolated Fibrinogen Deficiency in a Patient with Lung Adenocarcinoma after Surgery (ID 9177)
09:30 - 09:30 | Author(s): Y.D. Kim
- Abstract
Background:
Isolated fibrinogen deficiency is rare disease in Korean; especially extremely rare in patient with preoperative normal level of PT/aPTT.
Method:
I present a 62-year-old female patient who was admitted with lung cancer (adenocarcinoma, RUL, cT2aN0M0). She underwent VATS right upper lobectomy with mediastinal lymph node dissection. During operation, there was no need for transfusion (EBL 200cc) and no evidence of hemodilution.
Result:
On the first postoperative day (POD), PT was prolongated over 100 seconds (INR was over than 10). Coagulating factors were evaluated and isolated fibrinogen deficiency was diagnosed. As serum level of fibrinogen was fallen below 40mg/dL, spontaneous bleeding such as subcutaneous hemorrhage on trunk and persistent minor air leakage was observed. Bleeding tendency and air leak was improved since repeated transfusion of cryoprecipitate made the serum level of fibrinogen over 60 mg/dL. On POD 24, she was discharged without complication, however, she still had low level of fibrinogen. Although she was stable without any signs of spontaneous bleeding and prolongation of PT, the serum level of fibrinogen was still low around 60mg/dL at last visit in out-patient clinic which needed intermittent transfusion of cryoprecipitate. Figure 1
Conclusion:
She refused genetic evaluation for fibrinogen deficiency and I still don’t know what caused isolated fibrinogen deficiency in this patient, which could lead to a critical situation. To prevent any other disaster caused by this, I think there needs countermeasure for this.
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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
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.13-002 - Reduced Dose Perfusion CT of Lung Cancer using a 16-cm Coverage Scanner: Effects of Respiratory Motion Correction on Perfusion Assessment (ID 7464)
09:30 - 09:30 | Author(s): Y.D. Kim
- Abstract
Background:
Perfusion CT parameters have showed promising results for evaluation of tumor response and follow-up. However, clinical implications in patients with lung cancer have been relatively limited due to the fact that perfusion CT is performed while the patient is breathing and high radiation dose. Therefore, the purpose of this study was to evaluate the effects of respiratory motion correction on perfusion assessment of lung cancer in a reduced dose perfusion CT using a 16-cm coverage scanner.
Method:
Eighty four patients with primary lung cancer who underwent a reduced dose perfusion CT (80 kVp, 80 mA) were enrolled in this study. Each perfusion CT study included 25 repeated dynamic CT scans obtained using the volume perfusion software and was reconstructed with hybrid iterative reconstruction at a strength level of 50%. Two observers measured blood flow (BF), blood volume (BV), and permeability of the entire tumor with and without the use of non-rigid registration algorithm. Single-measure intraclass correlation coefficients (ICC) were calculated and interobserver reproducibility for parameters obtained with two different manners were assessed through Bland-Altman analyses.
Result:
CTDIvol obtained with each of the dynamic perfusion CT in this study was 36.16 mGy and the estimated mean effective dose ranged from 2.02 mSv to 4.0 mSv. Using non-rigid registration, all ICC values for BF, BV, and permeability were increased (0.982~0.994 to 0.988~0.997) compared with those obtained before application of non-rigid registration. All ICC values of lower lung tumor (0.991~0.998) or tumor ≤ 3 cm (0.989~0.998) were higher than those of upper lung tumor (0.925~0.984) or tumor > 3 cm (0.975~0.996). Using non-rigid registration, all 95% limits of interobserver reproducibility were narrowed compared with those obtained before application of non-rigid registration, regardless of tumor location or tumor size, except those of BV for tumors located in upper lung and tumors > 3 cm.
Conclusion:
Perfusion assessment of lung cancer using a reduced dose perfusion CT scan is clinically feasible and application of respiratory motion correction using non-rigid registration can reduce measurement errors.
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-006 - Impact of Limited Resection or Omitted Adjuvant Therapy in Patients with Pathologic Stage II and III Non-Small-Cell Lung Cancer (ID 9614)
09:30 - 09:30 | Author(s): Y.D. Kim
- Abstract
Background:
There is consensus for the treatment modalities of lung cancer. However, there were cases in which inadequate treatments were performed due to unavoidable reasons which could make different oncologic outcomes. So authors investigated factors affecting oncologic outcomes in patients with pathologic stage II and III lung cancer who underwent limited resection or omitted adjuvant therapy.
Method:
From January, 2010 to December, 2012, 231 patients underwent operation for non-small-cell lung cancer in our hospital. Of them, 63 patients who were diagnosed as pathologic stage II and III were enrolled in this research, and medical records of them were reviewed including demographic factors, treatment modalities, 5-year overall survival rate, 5-year recurrence and so on.
Result:
The mean age was 64.03±7.94 years old and preoperative performance status was good in all patients. The median follow-up duration was 58.7 [1.3, 88.4] months. Patients (group A) with resection more than lobectomy and adjuvant therapy were 50, patients (group B) with limited resection were 4, and patients with omitted adjuvant therapy were 13 (group C). 5-year overall survival rate of group A was 69.7% (stage IIA-84.4%, IIB-40.0%, IIIA-48.5%), but, all of group B were recurred and passed away. Of group C (stage IIA-9, IIB-1, IIIA-3), 5 were recurred and dead. Multi-variable analysis (Cox proportional hazard regression analysis) of prognostic factors for overall survival (OS) and recurrence (R) was performed, which showed limited resection (OS; hazard ratio 32.179, p=0.001 and R; hazard ratio 61.337, p=0.000) and pathologic stage (OS; hazard ratio 1.898, p=0.017 and R; hazard ratio 1.517, p=0.037) were presented as significant poor prognostic factors. And omitted adjuvant therapy didn’t significantly affect oncologic outcome, but had negative influence (OS; hazard ratio 8.102, p=0.074 and R; hazard ratio 5.528, p=0.13).
Conclusion:
This study has many weak points including small sample size, retrospective study and so on, but this study suggests that several factors affect prognosis in advanced stage non-small-cell lung cancer but, especially, the limited resection in advanced stage has been a significantly negative impact and should be considered carefully.
