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Kenichi Taguchi



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    P2.09 - Pathology (Not CME Accredited Session) (ID 958)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.09-30 - Clinicopathological Investigation of Four Resected Cases for Pleomorphic Carcinoma of the Lung (ID 12835)

      16:45 - 18:00  |  Presenting Author(s): Kenichi Taguchi

      • Abstract
      • Slides

      Background

      Pleomorphic carcinoma (PC) of the lung has a poor prognosis and no established standard treatment. Particularly, cases of recurrence after surgery often result in death within one year of recurrence. At our hospital, we experienced four cases of PC, and all these patients remain alive, including those with recurrence. We report these cases of PC together with our histopathological findings.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We examined four patients with PC who underwent thoracoscopic lobectomy and mediastinal lymph node dissection between October 2014 and March 2017. The histopathological findings were expression of programmed death ligand 1 (PD-L1) and CD8-positive tumor-infiltrating lymphocytes (CD8+TILs), which were examined for their relationship with prognosis. The expression of CD8+TILs was evaluated using the ratio of CD8+/CD45+ (leukocyte common antigen) TILs.

      4c3880bb027f159e801041b1021e88e8 Result

      pathological characteristics in each patiens.jpgWhile all patients survived, two of four patients experienced recurrence. Case 1 experienced recurrence 5 months after surgery and remains currently alive 35 months after recurrence using radiation therapy alone. Case 2 developed pleural dissemination and recurrence 10 months after surgery and remains alive 29 months after recurrence with a good partial response to chemotherapy and immune checkpoint inhibitors (nivolumab). Case 3 and 4 are both alive without recurrence 28 months and 12 months after surgery, respectively. All cases have high PD-L1 expression (tumor proportion score >50%) and the CD8+/CD45+TILs ratio demonstrated a trend toward a higher expression in intratumor than invasive margin. Case 2 showed a good response to immune checkpoint inhibitors, despite the expression of CD8+TILs was the lowest of four patients. Case 4 had high expression of CD8+TILs, which might be associated with good prognosis in spite of locally advanced cancer.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The expression of CD8+TILs may be associated with prognosis of PC. We plan to continue investigating how PD-L1 expression and the CD8+TILs ratio are related to recurrence and therapeutic response.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P2.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 964)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
    • +

      P2.15-11 - Clinical Outcome of Pulmonary Resection for Non–Small Cell Lung Cancer in Extremely Elderly Patients (85-Year-Old or Over) (ID 14137)

      16:45 - 18:00  |  Author(s): Kenichi Taguchi

      • Abstract
      • Slides

      Background

      Surgical resection is considered to be an effective therapy in the elderly patients. In Japan, the number of surgical operations performed in the elderly patients has been increasing. We reviewed the outcome of surgical treatment and the determining indication of pulmonary surgery in patients aged 85 years or over.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We performed surgical resection for 27 lung cancer patients aged 85 years or over in our hospital from January 2007 to December 2016. The patients’ operative procedure, histological type, comorbidity, surgery-related complications, prognosis, and recurrence were retrospectively reviewed. We performed pulmonary surgery for elderly patients who have to be able to undergo pulmonary physiotherapy, have good performance status (0-1 in ECOG scale), and be free from psychological disorder such as dementia.

      4c3880bb027f159e801041b1021e88e8 Result

      There were 19 males and 8 females. Their mean age was 87.0 years (range: 85-93 years). The mean follow-up period after operation was 1585 days (range: 395-3255 days). Operative procedures include lobectomy (N=10), segmentectomy (N=8), and wedge resection (N=9). Histological type include adenocarcinoma (N=18), squamous cell carcinoma (N=7), adenosquamous carcinoma (N=1), and LCNEC (N=1). Pathological stage was ⅠA in 20 patients, ⅠB in 4patients, ⅡB in 2 patients, and ⅢA in 1 patient. 17 patients had comorbidity including coincidence of other malignancy, anti-coagulant therapy, history of the lobectomy, and others. No patients died from surgery or post-surgical complications. Morbidity rate was 14.8% (e.g. refractory pulmonary fistula, Atrial fibrillation, heart failure, atelectasis). 14 patients are alive, whereas 11 patients died from other diseases than lung cancer. 4 patients experienced recurrence, and 2 patients of those died. 5-year survival rate was 71.4%, and 3-year survival rate was 87.5%.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our study indicates that the surgical resection of non-small cell lung cancer benefits patients, even with extremely elder age (85-year-old or older). We consider patients with clinical stageⅠ are good candidates. The long-term prognosis is expected if we chose the patients in elderly people lung cancer definitely.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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