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S. Takahashi
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OA18 - New Insights in the Treatment of Thymic Malignancies (ID 408)
- Event: WCLC 2016
- Type: Oral Session
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:N. Girard, S.B. Watzka
- Coordinates: 12/07/2016, 11:00 - 12:30, Schubert 2
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OA18.05 - FDG-PET in Thymic Epithelial Tumors: An Evaluation of Only Resected Tumors (ID 5635)
11:00 - 12:30 | Author(s): S. Takahashi
- Abstract
- Presentation
Background:
[18]F-Fluorodeoxy glucose positron emission tomography (FDG- PET) is thought to be useful for predicting the histologic grade in thymic epithelial tumors (TETs). Although there have been many reports on the use of FDG-PET for evaluating TETs, no previous studies have included only resected cases. Therefore, we investigated the relationship between the degree of FDG-uptake in the tumor and either the WHO histologic subtype or the tumor stage in patients with resected TETs.
Methods:
We retrospectively reviewed FDG-PET findings in 112 patients with TETs (92 with thymomas and 20 with thymic carcinomas) resected at 2 institutes in Japan. The Spearman rank correlation coefficient was used to assess the association between the maximum standardized uptake value (SUV max) in the tumor and both the histologic subtype and tumor stage. The cut-off value of SUV max for differentiating thymoma from thymic carcinoma was calculated using a receiver operating characteristic (ROC) curve analysis.
Results:
The Table shows the relationship between SUV max in the tumor and the WHO histologic subtype. SUV max according to each tumor stage was 3.9 ± 1.7 (mean ± SD) in stage I (n = 89), 4.7 ± 1.7 in stage II (n = 3), 7.4 ± 5.3 in stage III (n =11), and 7.6 ± 3.9 in stage IV (n = 9). SUV max was strongly related to both the WHO histologic subtype and tumor stage (Spearman rank correlation coefficient = 0.485 and 0.432; p = 0.000 and 0.000, respectively). The optimal cut-off value of SUV max for differentiating thymoma from thymic carcinoma was 4.6, with a sensitivity of 80% and a specificity of 70%.SUV max ~Histologic subtype~ No. of patients ~Mean ± SD~ Range A 12 ~3.5 ± 1.3~ ~1.3 – 6.3~ AB 45 ~3.5 ± 1.3~ [1.2 – 6.9] B1 19 ~4.1 ± 0.9~ [2.5 – 6.5] B2 10 [4.2 ± 1.0] [2.7 – 5.9] B3 6 [4.8 ± 2.6] [2.4 – 8.6] Thymic carcinoma 20 [8.0 ± 4.7] [3.0 – 21.8] Total 112 [4.5 ± 2.8] [1.2 – 21.8]
Conclusion:
Our results suggest that FDG-PET is useful for differentiating thymoma from thymic carcinoma. Further studies will be needed to assess other potential clinical applications of FDG-PET for the evaluation of TETs.
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-031 - Survival Data of Postoperative Adjuvant Chemotherapy of Cisplatin plus Vinorelbine for Completely Resected NSCLC: A Retrospective Study (ID 5032)
14:30 - 15:45 | Author(s): S. Takahashi
- Abstract
Background:
Although the efficacy of postoperative adjuvant cisplatin (CDDP)-based chemotherapy, such as the combination of CDDP and vinorelbine (VNR) has been established for surgically resected non-small cell lung cancer (NSCLC), there has been some reports about the survival data of Asian patients treated with the combination of CDDP and VNR as adjuvant chemotherapy.
Methods:
We retrospectively have evaluated patient compliance and the safety of adjuvant chemotherapy with CDDP at 80 mg/m[2] administered on day 1 plus VNR at 25 mg/m[2] administered on days 1 and 8, every 3 weeks at the Shizuoka Cancer Center between February 2006 and October 2011 (Kenmotsu, et al. Respir Investig 2012). In this study, we evaluated survival data of these patients. Overall survival (OS) and relapse-free survival (RFS) after the start of adjuvant chemotherapy conducted by the Kaplan-Meier method to assess the time to death or relapse.
Results:
One hundred surgically resected NSCLC patients were included in this study. The characteristics of the patients were as follows: median age 63 years (range: 36–74); female 34%; never smokers 20 %; histology non-squamous/ squamous cell carcinoma 73%/ 27%; EGFR mutation mutant/ wild/ unknown 19%/23%/58%. Pathological stages IIA/IIB/IIIA were observed in 31/22/47%. The median time from surgical resection to the start of adjuvant chemotherapy was 44 days (range: 29–79 days). Median follow up was 5.6 years (range, 3.8 – 9.7 years). The five-year OS rate was 73% and the 2-year OS rate was 93%. The five-year RFS rate was 53% and the 2-year RFS rate was 62%. A univariate analysis of prognostic factors showed that patient characteristics (gender, histology, pathological stage) and dose intensity of cisplatin were not significantly associated with OS.
Conclusion:
Our results suggested that the prognosis of surgically resected NSCLC patients, who were treated with the combination of CDDP and VNR as adjuvant chemotherapy, might be better than previous results of adjuvant chemotherapies for NSCLC patients. This result can be influenced by the advances of diagnostic and surgical procedures, and the efficacy of chemotherapy including molecular target therapies.
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P2.05 - Poster Session with Presenters Present (ID 463)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.05-007 - Outcomes after Stereotactic Body Radiothrapy/Proton Beam Therapy or Wedge Resection for Stage I Non-Small-Cell Lung Cancer (ID 4409)
14:30 - 15:45 | Author(s): S. Takahashi
- Abstract
Background:
Recently, excellent results of stereotactic body radiotherapy (SBRT), proton beam therapy (PBT) for stage I non-small-cell lung cancer (NSCLC) have been reported, however any phase III trial comparing SBRT and surgery have not been completed yet. The aim of this study is to compare outcomes between SBRT, PBT and wedge resection (WR) for patients with peripheral stage I NSCLC who intolerable for anatomical resection, and analyze prognostic factors in this population.
Methods:
We retrospectively compared overall survival (OS), local recurrence rate (LRR), relapse-free survival (RFS) and cause-specific survival (CSS) between WR (n=172) and SBRT / PBT (n=188) for pathologically proven clinical stage I NSCLC in our institute from 2002 to 2015. Patients underwent WR were all high risk patients who intolerable for anatomical resection and achieved complete resection without any adjuvant therapy. Of radiation group (RT: SBRT+PBT), 56% was medically inoperable, with 44% refusing surgery. SBRT; 60 Gy in 8 fractions, PBT; 60-80 GyE in 10-20 fractions was prescribed. Propensity score matching was used to adjust the confounding effects in estimating treatment hazard ratios. 59 WR patients and 59 radiotherapy (RT) patients (SBRT 27, PBT 32) were matched blinded to outcome (1:1 ratio). There are 70 men and 48 women, median age was 81, and median follow-up period was 39 months.
Results:
3, 5 - year overall survival (OS) of WR and RT was 84.5%, 70.8% vs 89.7%, 59.6% (p=0.802), respectively. 3-year LRR, RFS, CSS were 94.7% vs 95.9% (p=0.751), 87.5% vs 75.6% (p=0.151) and 91.2% vs 93.9% (p=0.875), respectively. Multivariate analysis of prognostic factors for OS demonstrated any factors including treatment modality were not significant.
Conclusion:
Our results suggest that the treatment outcome of SBRT / PBT was equivalent to that of WR, SBRT / PBT may be alternative treatment in stage I NSCLC high risk patients.
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P3.04 - Poster Session with Presenters Present (ID 474)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.04-004 - The Risk Factor of the Thrombus Formation in Pulmonary Vein Stump after Left Upper Lobectomy for Lung Cancer (ID 5105)
14:30 - 15:45 | Author(s): S. Takahashi
- Abstract
Background:
It has been known that thrombosis in the pulmonary vein (PV) stump after lobectomy could possibly be the cause of embolism of vital organs including cerebral infarction. Several studies have proved that left upper lobectomy is the risk factor of thrombus forming in the PV stump. The aim of this study was to clarify the risk factors of thrombus forming in the PV stump after left upper lobectomy for lung cancer.
Methods:
At our institute, 342 patients underwent left upper lobectomy for lung cancer from September 2002 to December 2013. Among them, 296 patients who received follow-up enhanced CT after surgery were retrospectively analyzed to see whether the thrombus in the left superior pulmonary vein (LSPV) stump would be detected. We analyzed the risk factors for thrombosis formation by uni-, and multivariate analysis.
Results:
Thrombus in the LSPV stump was formed in 21 patients (7.1%). Body Mass Index (BMI) of the thrombus forming group (median, 23.64; range 20.03 to 28.99) was significantly higher than the no-thrombus-forming group (median, 22.06; range 13.37 to 30.57; p=0.022). Univariate analysis revealed that significant risk factors include high BMI (p=0.022), no history of malignant disease (p=0.045), history of ischemic heart disease (p=0.049), cut LSPV at peripheral branch (p=0.029), pN2 (p=0.005), pStage III or higher (p=0.007), and adjuvant chemotherapy (p=0.005). In multivariate analysis, only pStage III was the significant risk factor.
Table1. Multivariate Analysis of Clinicopathologic FactorsOdds Ratio 95% Confidence Interval p Value BMI 1.170 0.992 - 1.379 0.061 History of malignant disease 0.288 0.037 - 2.273 0.238 History of ischemic heart disease 3.485 0.952 - 12.756 0.059 Cut LSPV at peripheral branch 3.611 0.801 - 16.272 0.095 pStage III or IV 3.830 1.394 - 10.524 0.009
Conclusion:
Thromboses were formed frequently after left upper lobectomy for advanced lung cancer.
