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Junji Yoshida

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    MS15 - Disruptive Technology and Lung Cancer Risk (ID 794)

    • Event: WCLC 2018
    • Type: Mini Symposium
    • Track: Prevention and Tobacco Control
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 10:30 - 12:00, Room 201 BD
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      MS15.04 - The Rise of Heat-Not Burn Tobacco in Japan: A “Hot” Issue for Tobacco Control (ID 11466)

      11:15 - 11:30  |  Presenting Author(s): Junji Yoshida

      • Abstract
      • Presentation
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      Abstract not provided

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    P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.16-40 - Delayed Cut-End Recurrence After Wedge Resection for Pulmonary Ground-Glass Opacity Adenocarcinoma  (ID 11958)

      12:00 - 13:30  |  Author(s): Junji Yoshida

      • Abstract


      Most pulmonary ground-glass opacity (GGO) nodules indicated by high resolution computed tomography (HRCT) are pathologically well differentiated adenocarcinomas.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We performed a limited resection trial of GGO lesions 2cm or smaller from 2003 to 2009, in which accumulated 95 patients were included. The lesion had to be a pure or mixed GGO nodule with a tumor disappearance ratio of 0.5 or greater on HRCT. We confirmed negative surgical cut-end during surgery by margin lavage cytology. Case: In the trial, a 51-year-old man underwent right lower lobe wedge resection for a 1.7 cm mixed GGO lesion. The tumor was papillary predominant adenocarcinoma, pT1NxM0. The resection scar started to become thicker 8 years after the initial surgery. When the lesion grew larger at 10 years, it was diagnosed as adenocarcinoma by needle biopsy. We performed a right lower lobectomy and lymph node dissection.

      4c3880bb027f159e801041b1021e88e8 Result

      Pathologically, the second tumor was adenocarcinoma similar to the initial one, papillary predominant with lepidic and acinar components. No pleural or vessel invasion was identified, and there were no nodal metastases. Cut-end staples and sutures used during the initial surgery to control air leakage were identified within the tumor. Genetically, 2 specimens from the initially resected GGO adenocarcinoma were studied and showed no epidermal growth factor receptor (EGFR) gene mutation or echinoderm microtubule-associated protein-like 4 (EML4) - anaplastic lymphoma kinase (ALK) fusion gene. A needle biopsy specimen from the second adenocarcinoma also had no EGFR mutation or EML4-ALK fusion gene, however, the lobectomy specimen had EGFR mutation (L858R in exon21).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Small papillary-predominant adenocarcinoma might develop delayed cut-end recurrence more than 5 years after limited resection. Careful follow-up with special attention to the cut-end[S1] is necessary ideally for 10 years.