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Takeshi Mori
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P1.15 - SCLC/Neuroendocrine Tumors (ID 701)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.15-014 - Can Limited Resection Be Accepted as an Alternative Treatment Option for Patients with Early-Stage Small Cell Lung Cancer? (ID 9744)
09:30 - 16:00 | Author(s): Takeshi Mori
- Abstract
Background:
Surgical resection can be considered for the treatment option for early-stage small cell lung cancer (SCLC). However, few reports have evaluated the use of limited pulmonary resection for patients with SCLC. This study was undertaken to evaluate the clinical impact of limited resection for SCLC patients with c-stage I.
Method:
We retrospectively analyzed surgically resected 40 SCLC patients with c-stage I from 2006 to 2016. We compared patients who underwent limited resection and those who underwent curative resection. In addition, factors affecting survival and recurrence were evaluated by Kaplan-Meier survival and Cox regression analysis.
Result:
Sixteen patients who underwent limited resection, including 13 wedge resection and 3 segmentectomy, were compared with 24 patients who underwent curative resection, including lobectomy and pneumonectomy. All patients were considered to be treated with standard chemotherapy or chemoradiotherapy. Twenty eight patients with pure SCLC and 12 patients with combed SCLC were identified. Histological examination showed a component of adenocarcinoma in 3 cases, squamous cell carcinoma in 4 cases, large cell neuroendocrine carcinoma in 4 cases and adenosquamouns cell carcinoma in a case. The median age was 73 years old (range, 39 to 90), and six (15.0%) patients were female. Almost all patients (39 out of 40; 97.5%) had a smoking history, and median pack-years was 53.5 (range, 0-150). Mean follow-up for cancer survivors was 33.0 months. In patients who underwent limited resection, significantly worse 5-year overall survival (5-OS) and 5-years disease-free (5-DFS) survival were observed compared to patients who underwent curative resection (5-OS; 20.4 months vs. 27.3%, p-value = 0.03, 5-DFS; 14.8 months vs. 36.5 months, p-value=0.04). Among patients who underwent limited resection, 5 patients experienced intrathoracic recurrence. Limited resection for patients with SCLC is associated with an increased risk of intrathoracic recurrence compared with those who underwent curative resection (hazard ratio 0.136, p=0.075).
Conclusion:
Surgical resection followed by chemotherapy or chemoradiotherapy can be a treatment option for early-stage SCLC, however limited resection increased the risk of recurrence and was associated with poor survival significantly. For patients who can not tolerate curative resection, limited resection may not be an effective therapeutic alternative.
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P1.16 - Surgery (ID 702)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.16-002 - Management of Local Recurrence after Segmentectomy for Stage IA Lung Cancer (ID 7417)
09:30 - 16:00 | Presenting Author(s): Takeshi Mori
- Abstract
Background:
Segmentectomy is thought to be able to spare lung parenchyma compared with lobectomy. On the other hand it might cause more local recurrences. The management of local recurrence after segmentectomy is thought to be an important issue. The aim of this study is to evaluate the management of local recurrence after segmentectomy.
Method:
From June 2005 to March 2009 we performed segmentectomy for clinical stage IA lung cancer, 88 male and 91 female with mean age of 66 year-old (32-83). The histological types of 179 lung tumors according to WHO histological classification are as follows: atypical adenomatous hyperplasia (2), adenocarcinoma in situ (34), minimally invasive adenocarcinoma (27), invasive adenocarcinoma (96), Squamous cell carcinoma (2), adenosquamous carcinoma (4), and carcinoid (2), respectively. Median follow-up time was 2920 days. During follow up there were 15 recurrences. Of 15 cases with recurrence 6 cases had local recurrences without distant metastasis.
Result:
Figure 1Mean time to local recurrence after segmentectomy was 1595 ± 1027 days (356－2965). Of 6 cases with local recurrence 5 cases had micropapillary component more than 5 %. The initial treatments for local recurrence were as follows: completion lobectomy (4), radiation (1), radiofrequency ablation (1), respectively. Three of 6 cases have been alive without evidence of disease since initial treatment for local recurrence of lung cancer.
Conclusion:
Management of local recurrence after segmentectomy is important. Local treatment, such as, completion lobectomy, radiation, or radio frequency ablation may effective for selected cases.
