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Yuichi Sakairi



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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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      P1.16-36 - Real-Time Ct Guided Video Assisted Thoracoscopic Partial Resection of Peripheral Small-Sized Lung Tumors. (ID 13502)

      16:45 - 18:00  |  Author(s): Yuichi Sakairi

      • Abstract
      • Slides

      Background

      As pulmonary resection for small and grand-grass opacity (GGO) dominant pulmonary nodules have been increasing, various navigation systems to detect these nodules have been reported. The aim of this study is to evaluate feasibility of real-time CT guided pulmonary resection for impalpable small pulmonary nodules.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      From July to November in 2017, 11 patients were eligible for pulmonary resection for lung cancer or malignancy suspected lesions, which was expected to be difficult to detect during operation. These nodules were defined as GGO-dominant (>50%) tumor with a diameter of 3cm or lower (GGO-dominant type), and tumor with a diameter of 2cm or lower, which is located deeper than the diameter of the tumor from visceral pleura (deep solid type). First, we put several surgical clips as first marker on the visceral pleura of the tumor-located lobethrough 3-ports VATS approach. The tumor and the first markers were visualized by cone beam CT, then the second marker was put just on the tumor based on the image. Pulmonary resection was performed according to second marker guided by automated staplers. CT scanning was also performed for confirmation of the complete resection.

      4c3880bb027f159e801041b1021e88e8 Result

      These procedures were performed for 4 men and 7 women (mean age: 58 years (39-71)). Tumors were located in the right upper lobe/right lower lobe/left upper lobe/left lower lobe in 5/2/2/2 patients. Diameters of tumors were 1.5cm or less. Six tumors were GGO-dominant types whereas 5 were solid types located in the deep from the visceral pleura; therefore all tumors couldn’t be detected by video-scopic observation. The average number of cone beam CT scanning is 2.7 times. All patients accomplished macroscopic and microscopic complete resection with no adverse events during perioperative periods.

      8eea62084ca7e541d918e823422bd82e Conclusion

      This feasibility study suggested that cone beam CT was safe and useful guide forvideo assisted thoracoscopic partial resection for impalpable peripheral pulmonary nodules.

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      6f8b794f3246b0c1e1780bb4d4d5dc53

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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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      P3.16-09 - High Preoperative D-Dimer Level Predicts Early Recurrence After Surgery for Non-Small Cell Lung Cancer (ID 11928)

      12:00 - 13:30  |  Author(s): Yuichi Sakairi

      • Abstract

      Background

      Carcinoma cells often affect the coagulation and fibrinolysis among cancer patients. Plasma dimerized plasmin fragment D (D-dimer) has been reported as the prognostic marker of various type of malignancies. For non-small cell lung cancer (NSCLC) patients, significance of D-dimer levels still remains unclear.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Two hundreds and thirty five patients with NSCLC who underwent radical surgery between April 2015 and March 2017 were retrospectively reviewed. We divided two groups including 1) high D-dimer (over 1.0ug/mL) group (hDD group, n=47), and 2) normal D-dimer group (nDD group, n=188). The clinical characteristics, tumor CT findings, pathological findings, and clinical outcomes were analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      The mean D-dimer level was 2.49±2.58 among hDD group. The hDD group had the character of 1) male gender, 2) elder patients, 3) larger tumor size (p=0.0011), 4) pure solid appearance (p=0.0203). The hDD group showed worse overall survival (OS), disease free survival (DFS), and disease specific survival (DSS) than nDD group (Figure 1-A, B, C; log-rank test, p<0.0001, =0.0007, =0.0003, retrospectively) and these findings were also observed only for the p-Stage IA cases. Interestingly patients with grand glass attenuation-dominant nodule were not affected by D-dimer level with favor prognosis. Pathology showed more frequent vessel involvement (v+) in hDD group (p=0.033), but there was no significant difference for histology or histological subtypes of adenocarcinoma.os_dfs_dss2.png

      Figure1:

      Kaplan-Meier survival curves of postoperative overall survival (A), disease free survival (B), and disease specific survival (C) by preoperative D-dimer level.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The preoperative D-dimer level predicts the postoperative early recurrence and poor prognosis in the patients with NSCLC with pure solid appearance on chest CT.

      6f8b794f3246b0c1e1780bb4d4d5dc53