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H. Miyamoto
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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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P2.16-003 - Diagnostic Lobectomy for Indeterminate Pulmonary Tumor (ID 8018)
09:30 - 09:30 | Author(s): H. Miyamoto
- Abstract
Background:
For tissue diagnosis of an indeterminate lung tumor with a strong suspicion of lung cancer, wedge resection is sometimes difficult because of tumor size or location. Intra-operative needle aspiration biopsy can be considered when tumor biopsy via flexible bronchoscopy (FB), or using transthoracic needle aspiration biopsy (TTNA), fails to prove malignancy in tumors with a high rate of false negatives. There are numerous lesions where an easy wedge resection or TTNA cannot be carried out, and lobectomy followed by thorough pathological examination is required.
Method:
From April in 2010 through December in 2015, 30 patients with indeterminate lung tumors who underwent lobectomy (including 2 upper segmentectomy in the left upper lobe) followed by thorough pathological examination were reviewed. Right middle lobe lesion was excluded in this study.
Result:
Sixteen were men and 14 were women. The median age of the patients was 67 years with a range of 24 to 85 years). According to the size and location of the lesion, each case was classified in two patterns: deep nodule (18 patients, locates centrally, inner two thirds from the lung surface) or mass (12 patients, greater than 30mm in diameter). Tumor located in the right upper lobe/ right lower lobe/ left upper lobe/ left lower lobe in 13 (deep nodule/mass: 8/5) / 4 (deep nodule/mass: 3/1) / 7 (deep nodule/mass: 4/3) / 6(deep nodule/mass: 3/3) patients, respectively. Preoperative examination was chest computed-tomography/F-18 FDG PET/transbronchial biopsy through bronchofiberscopy in 30/24/19 patients, respectively. Pathological diagnosis were as followings: 25 primary lung cancer (13 adenocarcinoma, 1 adenosquamous cell carcinoma, 1 mucoepidermoid carcinoma, 4 bronchiolo-alveolar varcinoma, 1 pleomorphic carcinoma, 1 small cell carcinoma, 4 squamous cell carcinoma) / 1 inflammatory myoblastic tumor/ 1 metastatic carcinoma/ 1 organizing pneumonia/ 1 caseous granuloma/ 1 Non Tuberculous Mycobacteriosis(Mycobacterium xenopi). Pathological stages of primary lung cancer were stage IA/IB/IIB/IIIA/IV in 6/1/3/2/1/3 patients, respectively. Operative time was 110~304 minutes (median: 182.5 min), and intra-operative blood loss was 0~530ml (median: 60 ml). Post-operative drainage were 2~18 days (median: 3 days) and post-operative hospital stay was 5~23 days (median: 10 days). Post-operative complications of Clavien-Dindo grade grater than or equal to II occurred in 6 patients (II/III: 3:3), all of them resolved conservative therapy.
Conclusion:
Diagnostic lobectomy followed by thorough pathological examination were carried out safely with acceptable range of postoperative complications.
