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Masayuki Okui

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    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • 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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      P3.01-112 - The Prognosis of Lung Cancer Patients with Unexpected Malignant Pleural Effusion and Without Pleural Dissemination Detected at Thoracotomy (ID 11313)

      12:00 - 13:30  |  Author(s): Masayuki Okui

      • Abstract
      • Slides


      Generally, primary lung cancer patients with malignant pleural effusion are not candidate for surgery. But in cases, we have no choice but to perform the surgery for biopsy, prevention for obstructive pneumonitis. We analyzed the surgery for lung cancer patients with unexpected malignant pleural effusion retrospectively.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed the patients with unexpected malignant pleural effusion and without pleural dissemination detected at thoracotomy underwent surgery in our hospital from 2003 to 2017. Pleural effusion was almost small amount (<50ml), and we included the cases that pleural effusion was malignant in the final report however it was suspicious in intraoperative report. Patient demographics, comorbidity, pathological findings, surgical approach, number of lymph nodes harvested, overall survival were evaluated retrospectively. Overall survivals were analyzed with the Kaplan–Meier method and prognostic factors were analyzed with the Cox proportional hazards model.

      4c3880bb027f159e801041b1021e88e8 Result

      24 patients underwent resection for NSCLC. The median age was 71 years old (56-79 years old) and 7 cases were male. Pleural effusions of all patients were taken before resection and submitted for rapid diagnosis. The reason we performed surgery was because we judged that we could perform surgery because of pulmonary nodule diagnosis and prevention of obstructive pneumonitis and so on. Surgical procedures were lobectomy in 15 cases, segmentectomy in 1, wedge resection in 8. The median size of resected nodule was 2.7cm (1.1cm-10.0cm). Histological types of lung cancer were adenocarcinoma in 21 cases, squamous cell carcinoma, adenosquamous carcinoma and small cell carcinoma each in 1. There was no surgical-related death or severe complications. The median follow-up time was 40 months and median survival was 66 months. At 5 years after pulmonary resection, 9 patients (38%) were dead. 5-year survival was 59.7% and 70.0% at cT1-2N0 patients, respectively. In a previous report, 5-year survival on resected stage I patients was almost 75%, and it is almost as good prognosis as our cT1-2N0 patients. Univariate analysis of gender, age, lymph node dissection, pathological findings (PL, ly, v, histology), surgical procedure and Brinkman Index were performed. Only PL0 or 1 was revealed as a prognostic factor (HR=0.12, p=0.049).

      8eea62084ca7e541d918e823422bd82e Conclusion

      The prognosis after surgery of lung cancer patients with unexpected malignant pleural effusion and without pleural dissemination may be better than expected and PL0 or 1 was thought as a prognostic factor. Thus, subsequent analysis should be performed to identify patients who could benefit from surgery.


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