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H.K. Kim
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P1.16 - Surgery (ID 702)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 2
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.16-012 - Application of Fluorescent and Iodized Dual Marker for Pre-Operative Localization and Image-Guided Surgery of Pulmonary Nodule (ID 9204)
09:30 - 09:30 | Author(s): H.K. Kim
- Abstract
Background:
This study evaluated the feasibility of pre-operative localization of pulmonary nodule using dual marker composed with indocyanine green (ICG) and lipiodol for minimal and accurate resection in video-assisted thoracoscopic surgery (VATS).
Method:
To minimize separation of two materials, we mixed with different frequency and ratio of ICG and lipiodol using a 3-way stopcock, and investigated their distribution with fluorescent microscope. Three rabbits were undergone thoracotomy after computed-tomography (CT) fluoroscopy-guidance injection of each 0.1 ml emulsions into different lobes of rabbit lung at 6, 12 or 24 hours. The localized lesions were evaluated by near-infrared optical imaging and radiograph. The 0.3 ml of emulsion was pre-operatively injected into 22 patients under CT fluoroscpy-guidance, and the localization was then evaluated during surgery by near-infrared imaging and mobile C-arm fluoroscopic x-ray. All freshly excised specimens were diagnosed by pathologic examination.
Result:
In in vitro, the separation time of ICG and lipiodol emulsion was delayed proportionally to mixing frequency and ratio. The emulsion mixed with 90 passages and 90% lipiodol was the least separated at 24 hours. On the rabbit lung, the optimal emulsion remained stably on injection site until 24 hours after injection. Pulmonary nodule localization using the optimal emulsion was performed successfully on the 22 patients without complications.
Conclusion:
This easy optimal method for pre-operative localization of pulmonary nodule was successfully established. The emulsion can be a useful marker to show the location of lesion to surgeons. However, ICG and lipiodol were not mixed perfectly and evenly. Therefore, there will be needed a future research to stabilize two materials completely.
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P1.16-021 - Midterm Oncologic Outcomes of Single Port Thoracoscopic Lobectomy for Lung Cancer by Propensity Matched Analysis (ID 10087)
09:30 - 09:30 | Author(s): H.K. Kim
- Abstract
Background:
Current evidence is still weak to establish the oncologic equivalence of single port thoracoscopic approach compared to conventional multiport thoracoscopic surgery as one of minimally invasive approach for lung cancer surgery. The purpose of this study is to evaluate the midterm surgical outcomes of single port approach compared to conventional multiport approach in thoracoscopic lobectomy for lung cancer.
Method:
A total of 228 patients in propensity matched group (both 114 patients with pathologic stage I who underwent lobectomy by conventional multiport or single port VATS) were compared the operative outcomes and we analyzed midterm survival and recurrence to evaluate the feasibility of single port VATS lobectomy for lung cancer.
Result:
Both propensity matched groups showed comparable preoperative variables (age, gender, FEV~1~, and tumor size) (Table 1). The mean operation time, the number of resected lymph node, and conversion to open thoracotomy or multiport VATS in both group did not show differences (respectively, P=0.076, P=0.291, P=0.253). There was no difference in postoperative major morbidity (P=0.807) and 30-day mortality (p=0.247). The duration of chest drain was shorter in single port VATS group (p<0.001) (Table 2). The survival (P=0.258) and freedom from intrathoracic recurrence (p=0.797) for mean 32 (6-62) months follow up in patients with pathological stage I were not statistically different between groups (Fig). Figure 1
Conclusion:
Single port thoracoscopic lobectomy in lung cancer showed acceptable oncologic outcomes for midterm follow ups with oncologic equivalence compared to conventional multiport thoracoscopic lobectomy.
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P3.02 - Biology/Pathology (ID 620)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.02-010 - Significant Increase of Blood Extracellular Vesicles in Pulmonary Vein as Potential Prognostic Biomarker for Lung Cancer Patients (ID 9973)
09:30 - 09:30 | Author(s): H.K. Kim
- Abstract
Background:
Exracellular vesicles(EVs) are endosome-derived nano-size (30-1000 nm) vesicles released from many cell types including cancer cells. Previous researches have demonstrated that the level of EVs is increased in cancer patients than healthy controls. This study was conducted to evaluate the variation of EVs-count in the proximal tumor-drainage vessel and peripheral vessels during surgery for VX2 rabbit lung cancer model and primary lung cancer patients
Method:
A total of 6 rabbits were used in this study (3 in normal group, 31 in lung cancer group). Rabbit VX2 lung cancer model was made by real-time computed tomographic guided inoculation of VX2 cancer. Two weeks after injection, blood was collected from rabbit peripheral vessel and pulmonary vein (proximal tumor-drainage vein). A total of 3 healthy controls and 31 patients with primary lung cancer who had pT2aN0 (stage IB) and underwent lobectomy were selected. For each patient, 3 ml of blood was sampled from the radial artery (peripheral vessel) before surgery and from pulmonary vein of the primary tumor site (proximal tumor-drainage vein) during surgical procedure. Healthy controls blood were collected from peripheral vessels. EVs were isolated by serial centrifugation followed by ExoQuick[TM] and quantitative analysis was performed by NanoSight and western blotting.
Result:
EVs-count was not different in normal rabbit model according to blood sampling sites (peripheral vessel: 2.78 x 10[8] particles/ml, pulmonary vessel: 2.64 x 10[8]; p = 0.104). However, in rabbit lung cancer model, EVs were increased by 623.5% in peripheral vessels (1.73 x 10[9 ]particles/ml; p = 0.003) and 787.9% in proximal tumor-drainage vein (2.08 x 10[9] particles/ml; p = 0.001) comparing to those of normal rabbits. Moreover, we confirmed that EVs-count in VX2 lung cancer model was increased by 120.0% (p = 0.05) on the proximal tumor-drainage vein than peripheral vessel. In human blood samples, peripheral blood derived EVs were increased by 181.6% in lung cancer patient in comparison with healthy controls (2.44 x 10[8] particles/ml in healthy control, 4.43 x 10[8] particles/ml in lung cancer patients; p = 0.04). And, EVs were significantly increased by 700.8% in pulmonary vein of the primary tumor site (1.71 x 10[9] particles/ml; p = 0.0001) comparing to peripheral vessels in lung cancer patients
Conclusion:
The increase of EVs was more prominent in tumor-drainage veins than peripheral vessels in animal cancer models and lung cancer patients. We suggest that increase of EVs from tumor-drainage veins may provide more relevant prognostic information of the lung cancer patients comparing to those from peripheral vessel after surgery.
