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Yoshinori Okada



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    P1.05 - Interventional Diagnostics/Pulmonology (Not CME Accredited Session) (ID 937)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.05-12 - <sup>18</sup>F-FDG PET/CT Findings May Predict Postoperative Acute Exacerbation of Interstitial Pneumonia in Lung Cancer Patients (ID 11131)

      16:45 - 18:00  |  Author(s): Yoshinori Okada

      • Abstract
      • Slides

      Background

      Acute exacerbation could be life-threatening for idiopathic interstitial pneumonia (IIP) patients. It is often challenging to choose a surgical treatment for a patient with IIP associated with lung cancer because lung resection is one of the risk factors of acute exacerbation. The objective of this present study was to investigate the correlation between preoperative findings of 18F-FDG PET/CT and postoperative acute exacerbation in patients with IIP associated with lung cancer.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed the data of 450 patients who underwent lung resection for non-small cell lung cancer between November 2012 and October 2017. We excluded patients who had preoperative radiotherapy (25 patients) from the analysis. All these patients preoperatively underwent 18F-FDG PET/CT for staging lung cancer. The maximum standardized uptake value ( was obtained.world-lc-2018_abst_fig1-tiff.tif

      4c3880bb027f159e801041b1021e88e8 Result

      CT findings of IIPs were found in 31 out of 425 patients (7.1%). Five out of 31 patients (16.1%) developed acute exacerbation after lung resection. These 5 patients had significantly higher SUVmax in the lesions of IIPs compared 26 patients without postoperative acute exacerbation.world-lc-2018_abst_fig2-tiff.tif

      8eea62084ca7e541d918e823422bd82e Conclusion

      This study demonstrated that 18F-FDG PET/CT findings may predict postoperative acute exacerbation of IIP in lung cancer patients.

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    P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.16-13 - Photo Dynamic Therapy (PDT) in Our Hospital (ID 12243)

      16:45 - 18:00  |  Author(s): Yoshinori Okada

      • Abstract

      Background

      Lung cancer is the leading cause of cancer death worldwide. A large part of lung cancer is diagnosed at an advanced stage, but the number of lung cancer diagnosed at an early stage are increasing due to improved diagnostic imaging techniques. In Japan, sputum cytology for mass screening provides chances to detect very early stage centrally located lung cancer which is good adaptation of PDT.

      Although PDT is less invasive therapy which enable us to treat the patients with poor pulmonary function or poor performance status. It is important to clarify the therapeutic outcome and the morbidity after PDT such as airway narrowing, pneumonia, and sunlight hypersensitivity.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We analyzed 14 patients who received PDT in Tohoku University Hospital between January 2010 and April 2017 retrospectively and evaluated the therapeutic outcome of PDT.

      4c3880bb027f159e801041b1021e88e8 Result

      14 cases were all male and the average age was 71. Nine cases were detected in cancer screening examinations and other 5 cases were detected accidentally while observing other diseases. Lung cancer existed in trachea 1, in segmental bronchi 4, in sub segmental bronchi 7, and more peripheral lesion 2. All 14 cases were pathologically squamous cell carcinoma. In 2 cases, we performed PDT twice. In 3 cases, we performed surgical resection after PDT. Within follow-up period after PDT, 5 cases developed metachronous lung cancer and were treated with surgical resection or radiation therapy. After these therapies 11 cases alive without recurrence, 1 case alive with recurrence, 1 case died from original disease, and 1 case died from other disease. Only one case suffered airway narrowing after PDT, but other 13 cases had no morbidity.

      8eea62084ca7e541d918e823422bd82e Conclusion

      We concluded PDT is a good treatment in early stage centrally located lung cancer with good outcomes and little morbidity rates.

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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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      P3.16-03 - Uncommon EGFR Mutations as a Worse Prognostic Factor for Surgically Resected Lung Adenocarcinoma (ID 12338)

      12:00 - 13:30  |  Author(s): Yoshinori Okada

      • Abstract
      • Slides

      Background

      The characteristics and prognosis of patients with lung adenocarcinoma harboring uncommon epidermal growth factor receptor (EGFR) mutations have not been clarified. Here, we examined whether the presence of uncommon EGFR mutations is a prognostic factor for patients treated surgically.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      In this multi-institutional retrospective cohort study, clinicopathological data were collected from 1,463 patients who underwent complete surgical resection for lung adenocarcinoma between 2005 and 2012 at five institutions and were examined for EGFR mutation status. Differences in postoperative overall survival (OS) and recurrence-free survival (RFS) according to EGFR mutation status were evaluated.

      4c3880bb027f159e801041b1021e88e8 Result

      Of 1,031 eligible patients, 500 (48.5%), 497 (48.2%), and 34 (3.3%) had wild-type EGFR (WT), common EGFR mutations (CMs), and uncommon EGFR mutations (UCMs), respectively. In the UCM group, 19 patients had a single mutation, including exon 18 G719X (n = 7), exon 20 T790M (n = 6), or exon 21 L861Q (n = 5), and 15 patients had compound mutations. The clinicopathological characteristics were not significantly different between the CM and UCM groups. The 5-year OS rates in the WT, CM, and UCM groups were 76.3%, 88.6%, and 68.4%, respectively. OS was significantly shorter in the UCM than CM group (p = 0.011), although no significant difference was observed between the UCM and WT groups (p = 0.83). The 5-year RFS rates in the WT, CM, and UCM groups were 63.7%, 75.4%, and 58.1%, respectively. RFS was significantly shorter in the UCM than CM group (p = 0.006), although no significant difference was observed between the UCM and WT groups (p = 0.41). The use of EGFR–tyrosine kinase inhibitors after recurrence did not affect the prognosis with respect to EGFR mutation type. Among those with single mutations in the UCM group, patients harboring T790M were younger, more likely to be males and smokers, and more likely to have a larger tumor size, lymph node metastasis, pleural invasion, and lymphovascular invasion, compared with those harboring G719X or L861Q. T790M was also associated with shorter OS and RFS; the 3-year OS rates were 50.0%, 83.3%, and 100% and the 3-year RFS rates were 16.7%, 71.4%, and 80.0% for patients harboring T790M, G719X, and L861Q, respectively.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Among patients with surgically resected lung adenocarcinoma, OS and RFS were significantly shorter in those with UCMs compared with CMs, implying that UCMs may be a worse prognostic factor.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P3.17 - Treatment of Locoregional Disease - NSCLC (Not CME Accredited Session) (ID 983)

    • 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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      P3.17-15 - Therapeutic Outcome of Surgery for Superior Sulcus Tumor (ID 12865)

      12:00 - 13:30  |  Author(s): Yoshinori Okada

      • Abstract
      • Slides

      Background

      Treatment of superior sulcus tumor (SST) is challenging and often requires multidisciplinary approach. Accumulation of treatment outcome is a principal issue for the future.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed clinical records of the patients those who were clinically diagnosed to have SST which involved to the 1st rib but was resectable. From 2000 to 2017, 16 patients were eligible in our hospital. Average age of the patients was 62.3 (40-74). The number of the patients with various properties was following; men 16/ women 3, right lung 5/ left lung 11, squamous cell carcinoma 5/ adenocarcinoma 9/ pleomorphic carcinoma 1, induction chemoradiotherapy 12/ induction chemotherapy 3/ no induction treatment 1, and clinical stage T3N0M0 9/ T3N2M0 2/ T4N0M0 4/ T4N3M0 1. Pathological information and clinical information regarding recurrence and survival were collected. Correlation between prognosis and clinicopathological factors were statistically evaluated by both univariate and multivariate analysis. P value was regarded as statistically significant when it was less than 0.05.

      4c3880bb027f159e801041b1021e88e8 Result

      Undertaken surgical approach was posterolateral for 8 cases/ median sternotomy for 6 cases/ transmanubrial approach (TMA) + thoracoscopy for 2 cases. Combined resection extended to the 1st rib for 6 cases/ 2nd rib for 4 cases/ parietal pleura for 4 cases/ vessels for 4 cases. For curativity, pathological curative (R0) was achieved in 12 cases, while macroscopic curative (R1) was noted in 4 cases. Effect of induction treatment was revealed as Ef1 for 4 cases/ Ef2 for 7 cases/ Ef3 for 2 cases. There was no death within 30 days after surgery. Morbidity (grade3) occurred in 6. Postoperative recurrence was observed in 8 cases and 7 of them dead from lung cancer. 5-year survival rate was 48.8%. By multivariate analysis, R0 resection was a statistically significant factor which correlates with survival.

      8eea62084ca7e541d918e823422bd82e Conclusion

      R0 resection was a critical factor for postoperative survival. Thoracoscopic approach combined with TMA might contribute to reduce surgical invasiveness according to the location of the disease.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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