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Hyeong Ryul Kim
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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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P1.16-020 - Outcomes of Pulmonary Metastasectomy in Hepatocellular Carcinoma According to Approach Method-Thoracoscopic Versus Open Approach (ID 9872)
09:30 - 16:00 | Presenting Author(s): Hyeong Ryul Kim
- Abstract
Background:
Proper management for pulmonary metastasis (PM) after control of primary hepatocellular carcinoma (HCC) has not been established and chemoradiation therapy has been largely ineffective. We investigated clinical outcomes of pulmonary metastasectomy and risk factors for survival rates, and disease-free survival rates in HCC with PM. With propensity score matching analysis, we compared the results according to surgical approach: video-assisted thoracic surgery (VATS) versus open (thoracotomy or sternotomy) method.
Method:
136 patients (112 men) underwent pulmonary metastasectomy for isolated PM of HCC from October 1998 to December 2010 at Seoul Asan Medical Center. 86 patients were operated by VATS (VATS group) and the other 50 patients were operated by thoracotomy or sternotomy (Open group). Propensity score analysis between VATS group and Open group was utilized and matched the groups by age, sex, level of preoperative AFP, treatment method for primary HCC, and PM characteristics (number, size, location, time to interval and range of resection).
Result:
There was no operative mortality and minor complication in 10 patients (7.3%) including prolonged air-leak. During 36 month-follow-up period, 112 patients (82.4%) experienced recurrence and 102 patients (75%) died of disease progression. Matching based on propensity scores produced 50 patients in each group for analysis of survival and disease-free survival. There were no survival and disease-free survival differences between matching VATS group and Open group. Multivariate analysis revealed hepatic recurrence, preoperative level of alpha-fetoprotein, liver cirrhosis to be an independent prognostic factor for survival and disease-free survival.
Conclusion:
Pulmonary metastasectomy may prolong survival in selected patients with HCC. VATS metastasectomy provided comparable outcomes to open metastasectomy in regard to survival rate and disease-free survival rate. Liver recurrence, preoperative level of alpha-fetoprotein, liver cirrhosis were independent prognostic factors for survival and disease-free survival.
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-014 - Post-Recurrence Survival Analysis of Stage I Non-Small Cell Lung Cancer-Prognostic Significance of Local Treatment (ID 9857)
09:30 - 16:00 | Presenting Author(s): Hyeong Ryul Kim
- Abstract
Background:
The aim of this retrospective study was to review recurrence patterns of stage I non-small cell lung cancer (NSCLC) and identify prognostic factors for post-recurrence survival (PRS).
Method:
Among 940 patients with pathological stage I NSCLC who underwent curative resection between 2001 and 2009, 261 patients who had experienced a recurrence were included in this study. A total of 188 patients had adenocarcinoma (ADC), and 62 had squamous cell carcinoma (SCC). Oligo-recurrence was defined as one to three locoregional or distant recurrent lesions restricted to a single organ. Potentially curative local treatment (PCLT) included surgery, stereotactic radiotherapy (SRT), and photodynamic therapy.
Result:
The median follow-up duration was 65 months (range: 4–186 months), and the median disease-free interval (DFI) was 23 months (range: 2–95 months). The most common site of recurrence was the lung in 145 patients, followed by a mediastinal lymph node in 49 patients, pleura in 30 patients, and brain in 27 patients. Local treatment for recurrent tumors included surgery in 59 patients, SRT in 46 patients, photodynamic therapy (PDT) in 2 patients, and other radiotherapy in 41 patients. Seventy-eight patients received chemotherapy only, and thirty-five patients received conservative treatment. Among 125 patients who were evaluated for an epidermal growth factor receptor (EGFR) gene mutation study, positive results were detected in 63 patients, and 31 were treated with a EGFR-tyrosine kinase inhibitor (EGFR-TKI). The 3- and 5-year PRS rates were 49.1% and 33.8%, respectively. Age at recurrence, ADC cell-type, DFI, TKI, and PCLT were independent prognostic factors in a multivariate analysis.
Conclusion:
local treatment for recurrent tumors could be a good option for selected candidates. Local treatment seems to be a reasonable modality for treating oligo-recurrence, even an extrapulmonary recurrence. Use of an EGFR-TKI is applicable if an EGFR mutation has been detected. Further study is required to identify patients who are optimal candidates for local treatment.
