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M. Hsieh
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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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P1.16-017 - Middle Term Survival Outcome of Single Port Video Assisted Thoracoscopic Anatomic Lung Resection: Two Center Experience (ID 9346)
09:30 - 09:30 | Author(s): M. Hsieh
- Abstract
Background:
Lung cancer is the leading cause of cancer-related death all over the world. Surgery is the treatment choice for patients with non -small cell lung cancer stage I through IIIA. Dr McKenna first described video-assisted thoracoscopic lobectomy (VATS) in 1994. Thereafter, VATS is like mushrooming rapidly spreading all over the world. During recent two decades, minimal invasive thoracoscopic anatomic lung resection with lymph node dissection is now widely accepted as a safe and oncological sound treatment option. The move forward minimal invasive VATS has driven the development of sophisticated instruments and different concepts to cope with the demanding need of working through smaller and fewer incision wounds. Until recently, single port VATS (SPVATS) is now being used for a growing number of applications, even including major lung resection for lung cancer. However, majority of single port VATS related studies are only related to its perioperative outcomes and feasibility. There are still few studies reporting its oncological results. The objective of this study is not only to evaluate the perioperative outcome but also to discuss the middle term oncological outcome in two medical centers’ experience
Method:
We retrospectively reviewed patients who underwent SPVATS anatomic resections between January 2014 and February 2017 in Coruña University Hospital and Minimally Invasive Thoracic Surgery Unit (Spain) and Chang Gung Memorial Hospital (Taiwan). Survival outcomes were assessed by pathological stage of American Joint Committee on Cancer (AJCC) 7th and 8th classifications
Result:
307 patients were finally enrolled in this study. The 2-year disease free survival and 2-year overall survival of the cohort were 80.6 %and 93.4% for 1A , 68.1 %and 84.3% for 1B , 67.5 % and 72.3% for 2A, 18.4% and %49.6 % for 2B , 52.2 % and 61.6 % for 3A, respectively forAJCC 7th classifications. For AJCC 8th classifications, there were 92.3% and 100% for 1A1, 73.7% and 91.4% for 1A2 , 75.2 % and 93.4% for 1A3, 60.9 %and 85.5% for 1B, 55.6% and 72.7 %for 2A, 60.5%and 84.3 % for 2B, 45.4 % and 62.4% for3A
Conclusion:
Our preliminary results revealed that SPVATS anatomic resection achieves non-compromised middle term survival outcomes for early stage lung cancer. For advanced stage NSCLC patients, further evaluation was warranted
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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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P3.13-001 - Clinical Significance of Chest Tomography Characteristics in Non Small Cell Lung Cancer Patients Who Received Anatomic Resection (ID 7423)
09:30 - 09:30 | Author(s): M. Hsieh
- Abstract
Background:
Characteristics of CT image, including tumor size and component were correlated to survival. However, most studies discuss the survival impact of image characteristics in early clinical stage populations. No articles were discussed the issue from the view of pathology stage, ie. actual disease presentations of non small cell lung cancer patients who presented as resectable disease. The aim of study was to analyze radiologic and pathologic findings of non small lung cancer patients who received curative resection in order to clarify he clinical correlation between image characteristics and survival impaction.
Method:
From 2010 January to 2014 May, 440 patients who underwent curative resection, ie. anatomic resection and mediastinal lymph node resection, were included and medical record were reviewed retrospectively. Chest CT characteristics, including tumor size and consolidation-tumor ratio, were re-evaluated and re-measured by radiologists. The correlation between image and pathology characteristics and its survival impaction were analyzed.
Result:
We identified tumor size presented in CT and pathologic measurement were highly coincidence. (p-value<0.001) The presentation of pure GGO and GGO predominant lesion were adenocarcinoma ( p< 0.001) Majority of these lesions ( 61/76, 80.2 %) were well differentiated. ( p<0.0001). In addition, pure GGO lesion has less risk for visceral pleura (p < 0.0001), angiolymphatic invasion (p < 0.002), and lower risk with N1 lymph node metastasis (p = 0.004) In addition, we found excellent disease free and disease free survival for patients who was identified GGO predominant lesion with size ≤ 2cm. (Figure 3) The difference of disease free (p= 0.0032, log rank test; Figure 3A) and overall survival (p= 0.0066, log rank test; Figure 3B) of these four subgroups was statistically significance. Figure 1
Conclusion:
Non small cell lung cancer patients who presented with ground glass opacity were corrected with well differentiated adenocarcinoma. In addition, less visceral pleura invasion, less angiolymphatic invasion, and less intrapulmonary lymph node metastases risk were also identified. Our results showed lung cancer patients who presented as GGO predominant lesions and size less than 2 cm may had excellent disease free and overall survival.
