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S. Hanada



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    P1.06 - Poster Session 1 - Prognostic and Predictive Biomarkers (ID 161)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Biology
    • Presentations: 1
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      P1.06-008 - Expression of PTRF/Cavin-1 is associated with poor prognosis of lung adenocarcinoma (ID 933)

      09:30 - 16:30  |  Author(s): S. Hanada

      • Abstract

      Background
      Polymerase I and transcript release factor (PTRF)/Cavin-1 was initially　identified as a regulator of rRNA transcription in the nucleus. It then was demonstrated to be essential to the formation of mature caveolae at the plasma membrane. Recently, downregulation of PTRF/Cavin-1 was reported in several types of cancers including non-small cell lung cancer compared to normal tissue. However, its precise expression pattern and clinical significance in lung adenocarcinoma remains unclear.

      Methods
      Proteomic analysis of 12 lung adenocarcinomas and the paired non-cancer lung tissue were preformed using iTRAQ coupled LC-MS/MS. To determine the expression pattern of PTRF/Cavin-1, we then performed immunohistochemical staining of PTRF/Cavin-1 on 186 adenocarcinoma tissues completely resected at Osaka City University Hospital from January 2005 to December 2008. To evaluate the clinical significance of PTRF/Cavin-1, the relationship between PTRF/Cavin-1 expression and clinicopathological parameters was analyzed.

      Results
      Proteomic analysis shows that expression level of PTRF/Cavin-1 is significantly lower in the cancer compared to the paired non-cancer lung tissue. This result suggests that PTRF/Cavin-1 may be involved in the development of lung adenocarcinoma. Immunohistochemistry analysis reveals that 30 cases (16%) were strongly positive for PTRF/Cavin-1 as observed in the non-cancer lung tissues, while 158 cases (84%) were negative. Furthermore, we found that overall survival rate of PTRF/Cavin-1-positve cases was significantly lower than that of negative cases (Log-rank test, p=0.0010). These findings imply that PTRF/Cavin-1 in cancer cells may facilitate the progression of lung adenocarcinoma progression.

      Conclusion
      These findings indicate that expression of PTRF/Cavin-1 in adenocarcinoma is associated with poor prognosis and might be a useful prognostic marker for lung adenocarcinomas.

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    P2.07 - Poster Session 2 - Surgery (ID 190)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P2.07-017 - Pulmonary Resection for Lung Cancer Patients with Cerebrovascular and Cardiovascular Comorbidities (ID 1509)

      09:30 - 16:30  |  Author(s): S. Hanada

      • Abstract

      Background
      Patients with cerebro- and cardio-vascular comorbidities (CCVC) who undergo surgery represent a high-risk group and require careful perioperative management. In the present study, we aimed to retrospectively analyze the postoperative complications (POC) of patients with CCVC who had undergone pulmonary resection for lung cancer. Patients with cerebro- and cardio-vascular comorbidities (CCVC) who undergo surgery represent a high-risk group and require careful perioperative management. In the present study, we aimed to retrospectively analyze the postoperative complications (POC) of patients with CCVC who had undergone pulmonary resection for lung cancer.

      Methods
      Among 288 patients who underwent pulmonary resection at our institution from January 2009 to December 2011, we examined the records of 51 patients with CCVC (17.7%) to identify the risk factors for developing POC. Among the analyzed patients, we noted the presence of 34 POC, including tachyarrhythmia in 9, prolonged pulmonary fistula in 9, pyothorax in 2, cerebral infarction in 2, requirement of long-term oxygen therapy in 2, interstitial pneumonia in 2, delirium in 2, and other POC in 4. Several patients had multiple POC.

      Results
      We examined 43 male patients (84.3%); the median age was 72 years and the median preoperative forced expired volume in 1s (FEV~1~) was 2200 mL (range, 1120–3420). The patients with CCVC included 12 with cerebral infarction, 2 with transient cerebral ischemic attacks, 2 with cerebral hemorrhage, 1 with subarachnoid hemorrhage, 4 with cerebral aneurysm, 10 with arrhythmia, 17 with ischemic heart disease, 1 with valvular heart disease, 8 with aortic aneurysm/dissection, 11 with peripheral arterial disease, and 1 with a left atrial myxoma; several of these patients had multiple CCVC. Moreover, 2 patients underwent pneumonectomy, 37 underwent lobectomy, 3 underwent segmentectomy, and 9 underwent wedge resection. Postoperative morbidity rates were 21.4% in cerebrovascular comorbidity patients (p = 0.015), 53.5% in the cardiovascular comorbidity patients (p < 0.0001), 71.4% in CCVC patients (p = 0.0028), and 12.3% in patients without CCVC. No operative or in-hospital mortality was noted. Gender, age, smoking status, and smoking index were not found to be significantly related to the incidence of POC. However, patients with an FEV~1~ < 2200 mL were found to be significantly more likely to develop POC (p = 0.036).

      Conclusion
      We noted that patients with CCVC and low FEV~1 ~were more likely to develop POC.

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    P2.24 - Poster Session 2 - Supportive Care (ID 157)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P2.24-014 - Primary Lung Cancer Coexisting with Lung Metastases from Other Malignancies (ID 1080)

      09:30 - 16:30  |  Author(s): S. Hanada

      • Abstract

      Background
      Various tumors metastasize to the lung and they are often detected as multiple nodules. Regardless of recent advances in computed tomography for detecting small pulmonary nodules and ground-glass opacity components which indicate possible primary lung cancer, preoperative differential diagnosis of either metastatic or primary lung cancer is usually difficult.

      Methods
      Four cases of such multiple lung metastases that coexisted with primary lung cancer were retrospectively examined: in three of the cases (case 1 is a myxoid liposarcoma in the right thigh, case 2 is a colon cancer, and case 3 is a renal cell carcinoma), a pulmonary metastasectomy revealed that one of the tumors was primary lung cancer. In case 4, the patient had a proven lung cancer that was combined with small nodules in the ipsilateral lung, one of which was pathologically diagnosed as a metastasis from rectal cancer.

      Results
      In case 1, the patient was diagnosed with clinical stage IA primary lung cancer (a well differentiated adenocarcinoma in the left lower lobe), and a left lower lobectomy was performed 17 days after the initial surgery. In case 2, a postoperative pathological examination revealed that one of the resected pulmonary tumors in the left upper lobe, measuring 5 mm in diameter, was Noguchi type B bronchioloalveolar carcinoma. In case 3, two nodules in the right lower lobe increased in size. An intra-operative pathological examination revealed that one of the pulmonary tumors in segment S9 measuring 7 mm in diameter was adenocarcinoma, and the other tumor in segment S8 located deeply near the pulmonary artery. Subsequently, a right lower lobectomy was performed. A postoperative pathological examination revealed that the tumor in segment S9 was Noguchi type A bronchioloalveolar carcinoma, and the other tumor measuring 8 mm in segment S8 of the resected lobe was metastatic clear cell carcinoma from renal cell carcinoma. In cases 2 and 3, the patients were diagnosed with clinical stage IA primary lung cancer and no additional treatment for lung cancer was required. In case 4, the patient, who had a history of rectal cancer, underwent left upper lobectomy with mediastinal lymph node dissection, combined with partial resection of the left lower lobe. A postoperative pathological examination using immunohistological staining revealed that the nodule in the left lower lobe and a hilar lymph node were metastasis from lung cancer (pT4N1M0, stage IIIA). The remaining nodule besides the tumor in the left upper lobe was diagnosed as metastasis from rectal cancer. The patient recovered uneventfully and was discharged with a treatment plan involving postoperative chemotherapy for lung cancer.

      Conclusion
      Possible coexistence of primary lung cancer should be considered in multiple metastases from other organs. On the other hand, the stage of the lung cancer depends on a definitive tissue diagnosis of the coexisting small nodules, and the importance of active tissue diagnosis including surgery should therefore be emphasized, especially in patients with previous malignancies.