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J. Okami
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MA 17 - Locally Advanced NSCLC (ID 671)
- Event: WCLC 2017
- Type: Mini Oral
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:S. Jheon, Georgios Stamatis
- Coordinates: 10/17/2017, 15:45 - 17:30, F203 + F204 (Annex Hall)
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MA 17.04 - Initial Surgery in Patients with Clinical N2 Non-Small Cell Lung Cancer: A Multi-Institution Retrospective Study (ID 7349)
15:45 - 17:30 | Author(s): J. Okami
- Abstract
- Presentation
Background:
There is no large scale study of the initial surgery for patients with cN2 disease who received positron emission tomography (PET). We investigated the outcomes of initial surgery for patients with cN2 disease who had received PET, by conducting a multi-institutional retrospective study.
Method:
Clinical data for 143 patients who had cN2 disease and underwent initial surgery at 12 Japanese institutions in Thoracic Surgery Study Group of Osaka University (TSSGO) between January 2006 and December 2013 were collected. After reviewing all the data for eligibility, completeness, and consistency, 8 cases were excluded. The remaining 135 cases were feasible for analysis. Among these patients, 98 received PET and were analyzed.
Result:
The median follow-up was 56.5 months (2-110 months). The median age was 67 (35-80) years. There were 71 males and 27 females. The histology was adenocarcinoma (n=66), non-adenocarcinoma (n=33). The tumor location was the right upper lobe and left upper segment (n=66, 67.3%), and the others (n=32, 32.6%). Of 98 patients, 85 (86.7%) had clinical single N2 disease and 80 (81.6%) had no mode of spread lesion and 90 (91.8%) underwent lobectomy. The 5-year relapse free survival (RFS) rate and the 5-year overall survival (OS) rate for patients with cN2 were 34.6% and 46.6%. There were 24 patients (24.9%) with cN2pN0,1 and 74 patients (75.5%) with pN2. Of 74 patients with cN2pN2 disease, 42 (59.5%) had pathological single N2 disease and 40 (54.0%) underwent adjuvant chemotherapy. The 5-year RFS for the patients with cN2 in the cN2pN0,1 and cN2pN2 groups were 62.2% and 26.0%, respectively (p=0.0025). The 5-year OS for the patients with cN2 in the cN2pN0,1 and cN2pN2 groups were 74.8% and 40.0%, respectively (p=0.029). Moreover, we provided the following 3 criteria: primary tumor in right upper lobe or left upper segment, N2 disease with regional mode of spread, and patients who did not undergo pneumonectomy. 60 patients who fulfilled all of these criteria were regarded as specific group. The 5-year OS for the patients with cN2 in the specific group and non-specific group was 55.8% and 32.0%, respectively (p=0.024).
Conclusion:
Among patients with cN2 disease, those with pN2 disease were more in number in our study than in previous reports. Our patients with cN2pN2 had better survival compared with those in previous reports. In particularly, patients with clinical N2 disease in specific group have a favorable prognosis. An initial surgery may be considered as a treatment option for these patients.
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P2.05 - Early Stage NSCLC (ID 706)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.05-010 - Changes between Pre- and Post-Operative AICS (Lung) in NSCLC Patients: Predictability of High-Risk Cases with Recurrence (ID 7915)
09:30 - 16:00 | Author(s): J. Okami
- Abstract
Background:
Plasma free amino acid (PFAA) levels are known to change in patients with malignant diseases. We have developed AminoIndex[TM] Cancer Screening (AICS[TM]) using “AminoIndex Technology”, which is a multivariate analysis of PFAA concentrations in various cancer patients and healthy controls. In Japan, AICS[TM] is now commercially available for simultaneous screening of seven cancer types, including lung cancer. The lung cancer specific AICS [AICS (lung)] are classified as rank A (AICS values: 0.0–4.9), rank B (5.0–7.9), or rank C (8.0–10.0); the closer to rank C, the higher risk of lung cancer. The aim of this study was to evaluate post-operative changes of AICS (lung) in patients who underwent curative surgical resection for lung cancer, as well as the associations of these changes with post-operative cancer recurrence.
Method:
The subjects were lung cancer patients with pre-operative AICS (lung) rank B-C, 44 patients (rank C; 29 cases, B; 15 cases) who underwent surgical curative resection. The pathological stage was 29 stage I, 8 stage II and 7 stage III. AICS (lung) was measured within 1 week prior to surgery and from 1.2 to 5.5 years after surgery, and the relationship between fluctuation before and after surgery and post-operative recurrence was analyzed.
Result:
Post-operative AICS (lung) ranks and values decreased in 52% (23/44) and 82% (36/44), respectively. For the pre-operative AICS (lung) rank C patients, post-operative AICS (lung) ranks and values decreased in 52% (15/29) and 86% (25/29), respectively. All 12 patients who had recurrence had a pre-operative AICS (lung) rank C. Among the 7 patients had recurred at the time of post-operative AICS (lung) measurement, 6 patients remained AICS (lung) rank C after surgery and 1 patient was rank B after surgery. On the other hand, among 5 patients in which recurrence was observed after post-operative AICS (lung) measurement, 4 patients remained post-operative AICS (lung) rank C and only 1 patient was rank B.
Conclusion:
Most patients had a decrease in the AICS (lung) rank and value after curative surgical resection. However, ten of 15 patients who had both pre- and post-operative AICS (lung) rank C had recurrence after surgery, suggesting the association between pre- and post-operative change in AICS (lung) and recurrence after lung cancer surgery. Pre- and Post-operative AICS (lung) measurement may be able to predict high-risk cases with post-operative cancer recurrent.
