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M. Aragaki



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    OA 04 - Surgery from Minimal to Radical (ID 661)

    • Event: WCLC 2017
    • Type: Oral
    • Track: Surgery
    • Presentations: 1
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      OA 04.02 - Feasibility of Pulmonary Resection Following Definitive Chemoradiotherapy for Primary Lung Carcinoma (ID 9633)

      15:55 - 16:05  |  Author(s): M. Aragaki

      • Abstract
      • Presentation
      • Slides

      Background:
      Induction chemoradiation (ICR) for advanced non-small cell lung caner is often limited to 50Gy or less to avoid perioperative complications. Pulmonary resection following definitive chemoradiotherapy (DCR) has been an alternative approach for locally advanced lung cancer.

      Method:
      In this study, we compared pulmonary resection following ICR and DCR. From 1997 to 2016, we had 31 pulmonary resections following CR. There were 13 ICR and 18 DCR. Intercostal muscle flaps were used in 7 ICR and 2 DCR. Omental flaps were used in 12 DCR. Pericardial fat pad was used in 1 DCR．There was no mortality in any groups.

      Result:
      In comparison with ICR and HCR, operation time (min, interquartile range) were 344 (283-513) and 418 (563-572) (p = 0.057), estimated blood loss (ml) were 440 (225-575) and 525 (323-1313) (p =0,262), morbidity (%), 69 and 28 (p = 0.021). Bronchopleural fistula developed in one case of DCR who used intercostal muscle flap. Post operation hospital stay (days) was 21 (13.5-26.5) in ICR, 14.5 (13-20) in DCR (P = 0.221). Although operation time was longer and there were more blood loss in DCR, there was no significant increase of peri- and post-operative complications. 2- and 5-year over all survival rates (%) were 50 and 42 in ICR, and 68 and 51 in DCR (p=0.73, log-rank test).

      Conclusion:
      As a conclusion, high dose ICR may contribute to better local control and longer survival. Pulmonary resection after DCR is as safe as that following ICR.

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    P1.17 - Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies (ID 703)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
    • Presentations: 1
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      P1.17-010 - The Diagnostic Value of Serum Cytokeratin Fragment 19 (CYFRA21-1) for Thymic Squamous Cell Carcinoma (ID 9407)

      09:30 - 09:30  |  Author(s): M. Aragaki

      • Abstract

      Background:
      Preoperative diagnosis of anterior mediastinal tumor has been depending on the radiographic findings and clinical findings. We investigated the diagnostic value of serum tumor markers in patients with anterior mediastinal tumor.

      Method:
      Consecutive anterior mediastinal tumor patients referred to our hospital who had examined either of the serum tumor markers (CEA, SCC, CYFRA 21-1) preoperatively and underwent radical surgery or surgical biopsy between January 1999 and February 2016 were retrospectively reviewed.

      Result:
      One hundred eighteen patients were eligible, including 16 thymic carcinomas, 48 thymomas, 11 lymphomas, 13 mature teratomas, 7 other malignant tumors, 23 other benign legions. Preoperative serum CYFRA 21-1 was significantly higher in thymic carcinoma group (median = 2.4 ng/ml) than other anterior mediastinal tumor group (median = 1.1 ng/ml, p = 0.0005), whereas CEA (median 2.0 vs 2.1) and SCC (median 0.7 vs 0.8) showed no significant difference. The ROC curves identified an optimal serum CYFRA 21-1 cut off value of 1.65 ng/ml for predicting the diagnosis of thymic carcinoma (AUC = 0.80; sensitivity = 76.9%, specificity = 79.3%; P = 0.046). Pre- and post operative serum CYFRA 21-1 were measured in 6 patients who underwent radical resection. All those patients showed decrease of serum CYFRA 21-1 after resection.

      Conclusion:
      To measure serum CYFRA 21-1 may help the diagnosis of thymic carcinoma. The level of CYFRA 21-1 reflected the condition of the tumor in each patients. The optimal serum CYFRA 21-1 cut off value for predicting the diagnosis of thymic carcinoma was 1.65 ng/ml.