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Y. Moriya



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    O13 - Limited Resections (ID 101)

    • Event: WCLC 2013
    • Type: Oral Abstract Session
    • Track: Surgery
    • Presentations: 1
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      O13.03 - Survival of 1963 lobectomy-tolerable patients who underwent limited resection for cStage I non-small cell lung cancer (ID 1030)

      10:30 - 12:00  |  Author(s): Y. Moriya

      • Abstract
      • Presentation
      • Slides

      Background
      Although the standard operation for lung cancer is lobectomy, precise preoperative diagnosis of the “very early” lung carcinomas may identify patients that can be treated by limited resection. Previous reports on limited resection included patients who were not candidates for lobectomy. The survival of non-small cell lung cancer (NSCLC) patients who were fit for lobectomy and underwent limited resection has not been studied in a large enough scale.

      Methods
      A nationwide multi-institutional project collected clinical data of patients who underwent limited resection (segmentectomy or partial resection) for clinical T1-2N0M0 non-small cell lung carcinoma, who were 75 years old or younger at the time of operation and were considered fit for lobectomy by the physician. Overall and disease free survival, freedom from recurrence were analyzed and factors affecting survival or recurrence were identified.

      Results
      The median age of 1963 patients was 63 years. The mean maximal diameter of the tumor was 1.4 ± 0.6 cm. The overall and recurrence free survival after limited lung resection was 93.7 % and 90.4 % at 5 years, respectively. The recurrence free proportion and local recurrence free proportion were 93.3 % and 98.4 % at 5 years, respectively. Prognostic factors in overall survival were pathologically proven lymph node metastasis, interstitial pneumonia, male gender, older age, complications (cardiac disease, diabetes etc.), radiological invasive cancer, and multiple lesions. The consolidation/tumor ratio on CT of ≤ 0.25 predicted good outcome especially in cT1aN0M0 disease. Prognosis and recurrence was not affected by the method of limited resection (segmentectomy (n=1225) or partial resection (n=738)).

      Conclusion
      If the patient was 75 years old or younger and was judged fit for lobectomy, the result of limited resection for cStage I NSCLC was excellent and was not inferior to the reported result of lobectomy for small sized NSCLC. The radiological noninvasive carcinomas rarely recur and are especially good candidates for limited resection.

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    P3.12 - Poster Session 3 - NSCLC Early Stage (ID 206)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P3.12-001 - Lung Krueppel-like factor KLF2 improve post-operative prognosis of lung adenocarcinoma correlation with chemokine receptor CCR7 and genetical mutations of p53. (ID 30)

      09:30 - 16:30  |  Author(s): Y. Moriya

      • Abstract

      Background
      Chemokines and chemokine receptors not only have the powerful ability in cancer metastasis and tumorigenesis, but also act as anti-tumorgenic ability. Lung Krueppel-like factor (LKLF, KLF2) is a member of the family of the Krueppel-like factors (KLFs).　KLF2 was initially described as a lung-specific transcription factor. KLF2 is reported to regulate some malignant cells. We examined and evaluated the effect of KLF2 on lung adenocarcinoma and the relationship of their mRNA expression with CCR7, EGFR and p53 genetical mutations in lung adenocarcinoma.

      Methods
      120 patients of stage I to IV with lung adenocarcinoma were included in this retrospective analysis. The expression of CCR7 and KLF2 mRNA expression in surgically resected lung adenocarcinoma specimens were examined and evaluated the relation to prognosis, the effect of EGFR and p53 genetical mutations. In addition the expression of CCR7 and KLF2 exprssion were analyzed with immunohistochemical analysis and measured their mRNA expression extracted from tissue sections of lung adenocarcinoma specimens by laser capture microdissection.

      Results
      High mRNA expression of KLF2 in lung cancer patients indicated significantly good prognosis than the groups of low expressions (p= 0.0066, HR= 2.008, 95% CI of ratio 1.215 to 3.319). The expression of KLF2 mRNA had relationships with CCR7, CCL21 and CCL19 mRNA expression in lung adenocarcinoma. Moreover the mRNA expression of KLF2 in lung adenocarcinoma specimens was influenced by the mutation of p53 mutation in lung cancer specimens. In addition the expression of KLF2 was confirmed with immunohistochemical analysis and was ditected mRNA expression extracted from tissue sections of lung adenocarcinoma specimens by laser capture microdissection.

      Conclusion
      We propose KLF2 as clinical good prognostic factors and that KLF2 has strong relation with CCR7, the ligands CCL19, CCL21 and p53 genetical mutation in lung adenocarcinoma.