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R. Nakahara

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    P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P1.02-019 - Effectiveness of Touch Cytology on the Staple Line in the Assessment of Resection Margins for Pulmonary Malignant Tumors (ID 2505)

      09:30 - 17:00  |  Author(s): R. Nakahara

      • Abstract

      Assessing the presence of cancer cells in resected margins following partial or segmental resection of malignant lung tumors is an important step when planning complete resection. When the tumor is deemed proximal to the resection margin, the policy at our hospital is to swiftly conduct touch cytology on the staple line of the resected tissue sample and, when positive, to perform additional resection. In the present study, we evaluated whether or not this strategy is appropriate.

      From among 161 patients who had a partial or segmental lung resection at our hospital between April 2009 and December 2013, forty-two patients who underwent touch cytology of resection margins were evaluated. Variables investigated were cytodiagnostic findings, tumor size and distance from margin, and subsequent occurrence of local relapse.

      Resection of lung metastasis was performed on 16 of the 42 patients, intentional limited resection for primary lung carcinoma was performed in 13 patients, and conservative limited resection was performed on 13 patients due to issues with their respiratory function and systemic condition. Two patients tested positive on cytodiagnosis of the resected margin; hence, the surgical procedure was modified from partial to segmental resection and from lung lobe and partial resection to resection of both lobes, respectively. Moreover, both of these patients underwent conservative procedures, and both tumors were adenocarcinoma. Mean tumor size (mm) in the metastasis group, intentional limited resection group and conservative limited resection group was 14 mm, 15 mm and 24 mm respectively, and distance to resection margin was 9.3 mm, 11.2 mm and 8.6 mm respectively. None of the 42 patients, including the 2 patients who tested positive, exhibited subsequent local relapse.

      Both the patients who tested positive on cytodiagnosis belonged to the conservative limited resection group and tended to have a larger tumor size than patients in the other groups. Inadequate distance from the resected margin with respect to tumor size increases the risk of a positive result at the resected margin. Of the 42 patients in the present study who underwent touch cytology of resected margins, none experienced subsequent local relapse, which implies the appropriateness of our evaluation method.