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Masato Aragaki

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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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      P3.16-20 - Feasibility of Limited Resection for Peripheral Small-Sized Non-Small Cell Lung Cancer According to FDG Accumulation and Imaging Findings (ID 12913)

      12:00 - 13:30  |  Presenting Author(s): Masato Aragaki

      • Abstract
      • Slides


      With the progress of diagnostic imaging modalities, such as CT and FDG-PET, the number of resectable lung cancer, particularly small peripheral lung cancer, is increasing. We focused on the SUVmax of FDG-PET as a prognostic factor for lung cancer and established criteria for limited resection on the basis of CT findings and SUVmax. Since 2007, we continuously monitored the recurrence and prognosis of non-small cell lung cancers (NSCLCs) resected using our criteria. Here, we report the results of this study.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between December 2007 and December 2015, 611 consecutive patients underwent surgery for NSCLC at our institution. Of these, 73patients with cT1aN0M0 who underwent limited resection (partial resection or segmentectomy) were enrolled. The criteria for undergoing limited resection were as follows: ①tumor GGO ratio of ≥0.75and ② tumor SUVmax of ≤1.5. GGO ratio was calculated using the following equation: GGO ratio=[(maximum diameter of the tumor) – (maximum diameter of tumor consolidation)] / (maximum diameter of the tumor). The group that met our criteria and underwent limited resection was designated as intended limited resection group (ILR group), and the group subjected to limited surgery without meeting the criteria treated as control group.

      4c3880bb027f159e801041b1021e88e8 Result

      The study included 35 men and 38 women with a median age of 65 (range, 36–84) years. In total, 51 patients who met our criteria were included in the ILR group, and 21 patients who did not meet the criteria were included in the control group. The control group was selected for limited resection in terms of complications, pulmonary hypofunction, and heart failure. Regarding surgical approach, in the ILR group, 19 patients underwent partial resection and 32 underwent segmentectomy; in the control group, 13 patients underwent partial resection and 8 underwent segmentectomy. According to our criteria, no relapsed cases were reported in the ILR group. Moreover, the 5-year overall survival rates of the ILR and control groups were 100% and 60.5%, respectively, and the disease-free survival rates were 100% and 56.0%, respectively, indicating a significant difference (P < 0.0001). In the control group, 6 patients showed the recurrence of lung cancer.

      8eea62084ca7e541d918e823422bd82e Conclusion

      In this study, we analyzed the feasibility of our criteria for performing limited resection on the basis of CT findings and SUVmax. In the ILR group, no relapsed cases were reported, suggesting that our criteria may be useful in determining patient’s eligibility for undergoing reduction surgery.


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