Author of

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  P2.17 - Treatment of Locoregional Disease - NSCLC (Not CME Accredited Session) (ID 966)

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

  • 27325

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    P2.17-14 - How Should Positive Margin for Bronchial Stumps (R1) Be Evaluated in Patients Undergoing Bronchoplasty for Lung Cancer? (ID 13637)

    16:45 - 18:00  |  Presenting Author(s): Kazunori Hata
    • Abstract
    • Slides

    Background
    Bronchoplasty for lung cancer is a surgical procedure aimed at respiratory function preservation and curability. And it may be performed for tumors exposed in the respiratory tract or tumors with lymph node extranodal invasion. "Surgical margin positive for bronchial stump" in bronchoplasty surgery has both out-of-wall and carcinoma in situ (CIS), but the difference is not detailed. In this study, we clarify how to evaluate bronchial stump in bronchoplasty.
    a9ded1e5ce5d75814730bb4caaf49419 Method
    Of 2221 patients of resected lung cancer performed in our hospital from January 2002 to December 2015, 130 patients (5.8%) underwent pulmonary resection with bronchoplasty. The patient's background and its prognostic factors were examined by using Kaplan-Myer method. In addition, we examined details of microscopic residual disease (R1) of bronchial stump.
    4c3880bb027f159e801041b1021e88e8 Result
    There were 101 males and the median age of patients was 67 years old. 19 cases performed sleeve pneumonectomy and 18 cases performed extended sleeve lobectomy. There were 34 cases of pN0, 49 cases of N1 and 49 cases of N2. 30-day mortality was 2.3% (3cases) and 14 cases were R1 resection. 11 of which were positive for bronchial stump. pN2 and incomplete resection cases were significantly poor prognosis (p=0.03, p=0.009). 5 of the 11 microscopic bronchial stump positive cases were due to CIS and 6 were due to out-of-wall positives. However, among these 11 cases, there was only one case of anastomotic recurrence. And there were no statistical differences, but CIS was often found in long-term surviving cases.
    8eea62084ca7e541d918e823422bd82e Conclusion
    In cases of pulmonary resection with bronchoplasty, pN2 and incomplete resection are poor prognostic factors. Even in bronchial stump positive cases of incomplete resection, there was only one case of local recurrence. And long-term surviving cases were observed. There are some CISs for long-term survival, but there is no statistical difference because of small cases. Further examination is required.
    6f8b794f3246b0c1e1780bb4d4d5dc53

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