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ORAL 35 - Surgical Approaches in Localized Lung Cancer (ID 155)
- Event: WCLC 2015
- Type: Oral Session
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
ORAL35.06 - Limited Resection for Non-Small Cell Lung Cancer Referring to Pathology (ID 216)
16:45 - 18:15 | Author(s): M. Yano
Precise preoperative diagnosis of the in-situ or minimally invasive carcinomas may identify patients that can be treated by limited resection. Though some clinical trials of limited resection for lung cancer have started, it will take much time to get results. We have reported a large scale data of limited resection at the previous WCLC meeting. We report here the data of subclass analysis according to the differences of pathology.
Data from multiple institutions was collected on 1,737 patients who had undergone limited resection (segmentectomy or wedge resection) for cT1N0M0 non-small cell carcinoma. As 11 patients without pathological diagnosis were excluded, 1726 patients were analyzed to determine the indication of limited resection in pathological differences. Disease free survival (DFS) and recurrence free proportion (RFP) were analyzed.
Median age was 63 years. Mean maximal diameter of the tumors was 1.4 ± 0.5 cm. DFS and RFP at 5 years were 91.0 % and 93.6 %, respectively. DFSs and RFPs at 5years in pathology were 92.2% and 94.7% in adenocarcinoma (n=1575), 76.3% and 82.4 % in squamous cell carcinoma (SqCC) (n=100), 100% and 100% in carcinoid (n=16), and 73.6% and 75.9 % in others (n=35). Adenocarcinomas were classified using 2 factors, the ratio of consolidation and tumor diameter (C/T) and tumor diameter into 4 groups, group A (C/T ≤ 0.25 and tumor diameter ≤ 2.0 cm), group B (C/T ≤ 0.25 and tumor diameter > 2.0 cm), group C (C/T > 0.25 and tumor diameter ≤ 2.0 cm), and group D (C/T > 0.25 and tumor diameter > 2.0 cm). DFSs and RFPs at 5 years were 96.7% and 98.8% in group A, 100% and 100% in group B, 89.2% and 92.3% in group C, and 76.7% and 77.8% in group D. In all groups of adenocarcinoma, the prognosis in patients who underwent segmentectomy was not superior to wedge resection.The prognosis in both groups A and B was good. These groups seemed to be good candidates of limited resection. The prognosis of group D were not good. Group D seemed not to be a good candidate of limited resection. Prognosis of group C was not bad, however, we could not conclude indication in group C because group C included both part solid tumors and solid tumors. In SqCC, tumor diameter was not prognostic factor and only segmentectomy was favorable prognostic factor (DFSs and RFPs in segmentectomy vs wedge resection: 78.2% and 85.5% vs 65.5% and 65.5%, respectively). In SqCC, there seemed to be indication of limited resection with segmentectomy. In carcinoid, all tumors except one were resected by segmentectomy. Segmentectomy for cT1 carcinoid seemed to be allowed. As prognosis in other pathologies was worse in limited resection, there seemed to be no indication of limited resection.
Pathological diagnosis was important to determine the indication of limited resection. Measurement of tumor diameter and C/T was useful to determine the indication of limited resection for adenocarcinoma.
P3.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 226)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
P3.08-033 - Expression of Excision Repair Cross-Complementation Group 1 and Class III β-Tubulin in Thymic Carcinoma (ID 1295)
09:30 - 17:00 | Author(s): M. Yano
Thymic carcinoma is a rare mediastinum malignant tumor based on thymic epithelial cells. The complete surgical resection is considered as a best treatment for thymic carcinoma. However, except completely resected cases, the effective therapy has not been established for the advanced or relapsed thymic carcinoma. The expression of excision repair cross-complementation group 1 (ERCC1) and class Ⅲ β-tubulin (TUBB3) protein are respectively expected as an indicator for the anticancer activity of the platinum-based and taxane-based chemotherapy.
We examined the expression of ERCC1 and TUBB3 protein in 40 thymic carcinoma patients who underwent either the surgical resection or the core-needle biopsy. We also evaluated the expression of ERCC1 and TUBB3 protein in 50 patients who underwent the curative resection for the non-small cell lung cancer (NSCLC). We investigated whether the expression of ERCC1 and TUBB3 protein were associated with some overall survival and clinic-pathological factors of thymic carcinoma patients.
The expression of ERCC1 and TUBB3 protein were positive in eight cases (20%) in thymic carcinoma patients. ERCC1 was expressed in twenty-one cases (42%), while TUBB3 was in twenty-seven cases (54%) in the fifty NSCLC patients. In all thymic carcinoma cases, the 3 year-survival was 67.3%. Only complete resection was associated with the better prognosis (p=0.0341). Other clinico-pathological factors including the expression of ERCC1 and TUBB3 protein showed no effect on the overall survival.
High expression of ERCC1 and TUBB3 might be associated with resistance to the platinum-based and taxane-based chemotherapy. Our results suggest a possibility of better antitumor effects of the platinum-based and taxane-based chemotherapy on the thymic carcinoma patients.