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T. Mori



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    P1.05 - Poster Session with Presenters Present (ID 457)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
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      P1.05-039 - Recurrence and Survival Outcome after Segmentectomy for Non-Small Cell Lung Cancer: A Long-Term Follow-Up Study at a Single Institute (ID 5011)

      14:30 - 15:45  |  Author(s): T. Mori

      • Abstract

      Background:
      This study aimed to investigate the factors associated with long-term outcomes of segmentectomy for non-small cell lung cancer (NSCLC) carried out at a single institute.

      Methods:
      179 patients with stage I NSCLC who underwent a segmentectomy between 2005 and 2009 were investigated. Histological classification was reassessed according to the criteria of the 2015 WHO.

      Results:
      179 patients with stage I NSCLC (159 adenocarcinomas (ADCs), 14 squamous cell carcinomas (SQCs), 4 adenosquamous carcinomas, and 2 typical carinoids) who underwent segmentectomy between 2005 and 2009 were investigated.The mean follow-up was 73 months. The 5-year overall survival (5-OS) and 5-years disease-free survival (DFS) were 91.8% and 90.2%, respectively. Seven cases of distant recurrence and 8 local-regional recurrence occurred. Multivariate analysis revealed that lymphovascular invasion (LVI) was the independent predictor of 5-OS (P=0.005), and part-solid GGO (GGO ratio < 50%) and LVI were that for 5-DFS (P=0.043, P<0.001). Among invasive ADC patients, micropapillary pattern (MIP) ≧ 5% was identified as an independent predictor of recurrence (P=0.005) and survival (P=0.007). There were five local recurrences in patients with MIP more than 5 years after segmentectomy. Figure 1



      Conclusion:
      LVI was an independent predictor of the recurrence and overall survival. In patients with invasive ADC, MIP≧5% was a multivariable predictor of recurrence and overall survival. In the patients who underwent a segmentectomy, 5 years without recurrence is not sufficient to conclude that patients with NSCLC is cured.

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    P2.08 - Poster Session with Presenters Present (ID 491)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Patient Support and Advocacy Groups
    • Presentations: 1
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      P2.08-008 - Regional Clinical Pathway for Lung Cancer in Kumamoto University Hospital (ID 4065)

      14:30 - 15:45  |  Author(s): T. Mori

      • Abstract
      • Slides

      Background:
      Although half of people in Japan live in rural districts, cancer centers locate in urban area. Cancer control act was intended to accomplish equal accessibility of cancer medical care across the whole extent of Japan in 2006. According to the act, regional clinical pathways have been started to use. The aim of this study was to evaluate the pathways.

      Methods:
      Patients with lung cancer who underwent surgery in Kumamoto University Hospital between April 2010 and March 2014 were included. Candidate for the pathway of lung cancer was selected by following criteria. 1) Patient who lives far from our hospital. 2) Patient who eagers to join the pathway. Data were examined retrospectively. Patients usually visit local clinic and undergo examination at our hospital every 6 month. The medical informations are shared with patients, their family and medical staffs with hand-held chart.

      Results:
      During the study 630 lung cancer patients underwent resection in our hospital. Pathological stages of these patients were, IA in 439, IB in 90, IIA in 37, IIB in 13, IIIA in 71, IIIB in 2, and IV in 15. Of these 681 patients, 67 (11%) entered the regional clinical pathway in our hospital with mean age of 70 ± 10 years old. Pathological stages of the patients who joined regional clinical pathway were, IA in 51 (12%), IB in 8 (9%), IIA in 3 (8%), IIB in 0 (0%), IIIA in 5 (7%), IIIB in 0 (0%), and IV in 0 (0%). Mean observation period was 1083 ± 496 days (62 – 2181). Seven patients died during the study. Ten patients cancelled the pathway. The reasons why the pathway discontinued were as follows: recurrence of lung cancer in 1, other cancer occurrence in 2, patients’ own decision in 4, clinic’s issue in 5. Forty eight patients continue to use the pathway at the end of the study (72%). Mean duration of the pathway the patients used was 993 ± 481 days (3 – 2181). Mean distance between patients’ home and our hospital was 43 ± 34 km (2.6 – 144.5). Because local clinics located closed to patients’ home (mean distance: 12 ± 13 km (0.1 – 55.3)), mean time they spend for attending hospital was reduced from 61 ± 41 minutes (8 – 210) to 19 ± 18 (1 – 83).

      Conclusion:
      The pathway was used in 72% patients at the end of study and reduced the time patients visiting hospital.

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