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Nobuhiko Sakao
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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.01-97 - Is Surgical Treatment Suitable for Stage III or IV Primary Lung Cancer? (Now Available) (ID 1269)
08:00 - 18:00 | Author(s): Nobuhiko Sakao
- Abstract
Background
Background: It is generally known that advanced lung cancer is not an indication for surgical treatment, whereas it is an indication for chemotherapy and/or immunotherapy. We examined cases in which surgery was performed for clinical stage III or IV lung cancer and investigated whether this treatment was effective or not.
Method
Methods: We retrospectively reviewed 34 patients who underwent radical resection for stage III or IV primary lung cancer at Ehime University Medical Hospital from October 2010 to February 2019.
Result
Results: In this series, 23, 5, and 6 patients had stage IIIA, stage IIIB, and stage IV disease, respectively. Following were the histological types: adenocarcinoma, 14; squamous cell carcinoma, 9; large-cell carcinoma, 5 (large-cell neuroendocrine carcinoma [LCNEC], 1); adenosquamous carcinoma, 1; pleomorphic carcinoma, 1; LCNEC + adenocarcinoma, 1; LCNEC + squamous cell carcinoma, 1; and LCNEC + small-cell carcinoma, 1. As preoperative treatment, 8 and 7 patients received full-dose chemoradiotherapy (salvage surgery) and induction chemoradiotherapy, respectively. We also included 2 cases involving salvage surgery after only chemotherapy and 1 case involving salvage surgery after chemotherapy and brain metastasis resection. The remaining 16 patients underwent surgery without any pre-surgical treatment. In addition, adjuvant chemotherapy was administered in 17 cases. In a mean observation period of approximately 4 years, the overall 3-year and 5-year survival rates were 57.2% and 30.6%, respectively. In patients with clinical stage IIIA disease, the 3-year and 5-year survival rates were 55.9% and 21.7%, respectively. In patients with clinical stage IIIB disease, the 3-year and 5-year survival rates were 75% and 50%, respectively. In patients with stage IV disease, the 3-year and 5-year survival rates were 50% and 33.3%, respectively. In patients without any multimodal treatments (n = 16), the 3-year and 5-year survival rates were 55.0% and 23.6%, respectively. In patients who underwent surgery after induction chemoradiotherapy (n = 7), the 3-year and 5-year survival rates were 85.8% and 42.9%, respectively. In patients who underwent salvage surgery (n = 11), the 3-year and 5-year survival rates were 41.7% and 41.7%, respectively.
Conclusion
Conclusion: Long-term survival can be achieved even in stage III or IV lung cancer patients by combining multimodal treatment with surgery in appropriate cases.
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EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.15-09 - Surgical Resection of Pulmonary Metastases from Hepatobiliary and Pancreatic Cancers (Now Available) (ID 3026)
08:00 - 18:00 | Author(s): Nobuhiko Sakao
- Abstract
Background
Hepatobiliary and pancreatic cancers account for 22% of all cancer deaths in Japan. Although these cancers have had a high mortality rate and have been poorly responsive to chemoradiation therapy, the survival of patients have been gradually improved with recent advances in diagnosis and treatment. Pulmonary metastases derived from hepatobiliary and pancreatic cancers have been a rare event and the management in such patients remains controversial. The aim of this study is to review our experience of pulmonary resection for metastatic hepatobiliary and pancreatic cancers, and to assess the feasibility of pulmonary metastasectomy.
Method
Clinical data of 7 patients who underwent pulmonary resection for metastatic hepatobiliary and pancreatic cancers from April 2010 to March 2019 at Ehime University Hospital were retrospectively reviewed. Disease-free interval was defined as the time between operations for the primary cancer and the metastatic lesion.
Result
The median follow-up period was 61 (range, 7 to 110) months. Primary diseases of these patients were hepatocellular carcinoma in 2, cholangiocarcinoma in 1, gallbladder cancer in 2 and pancreatic cancer in 2. There were 5 men and 2 women with mean age of 69 (range, 47 to 82) years. The median disease-free interval was 19 (range, 6 to 59) months and one patient with solitary metastasis was treated by lobectomy, the other 6 patients (3 solitary, 3 multiple) were treated by wedge resection. 5 surgeries were operated by VATS and the other 2 were operated by thoracotomy. There were 3 patients with incomplete resection. Additional treatments after metastasectomy were performed in 4 patients. Although no surgical complications and operative mortalities occurred, 2 patients died of primary diseases. Recurrence after pulmonary metastasectomy developed in 1 of 4 patients without incomplete resection. The longest survivor was still alive more than 5 years without recurrence after lung resection and the median survival period was 45 months.
Conclusion
Surgical resection of pulmonary metastases from hepatobiliary and pancreatic cancers are feasible and the postoperative survival is acceptable. But there are highly selective patients in our study, further study is needed to evaluate the efficacy of pulmonary metastasectomy.
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P1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 186)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.16-37 - Correlation Between the Actual Measurement Value After Lung Lobectomy and the Predicted Value of Forced Expiratory Volume in 1 Second (Now Available) (ID 1717)
09:45 - 18:00 | Author(s): Nobuhiko Sakao
- Abstract
Background
It is important to accurately predict postoperative respiratory function to safely perform lung resection without impairing the postoperative quality of life (QOL), particularly for patients with a significant ventilatory defect. To easily predict the vital capacity (VC) and forced expiratory volume in one second (FEV1), the number of pulmonary segments remaining after lung resection are divided by the total number of pulmonary segments (predicted value of FEV1).
Method
We performed a retrospective review of 386 consecutive lobectomies performed from June 2011 to December 2018 at the Ehime University Hospital. On the basis of the preoperative values of FEV1%, we made 4 groups: FEV1%< 50% (n=16), FEV1% ≥50% but <60% (n=29), FEV1% ≥60% but <70% (n=109), and FEV1% ≥70% (n=232). We compared the difference between the predicted value of FEV1 and the actual measurement value three months after the lobectomy.
Result
The scattergram in Fig 1. shows the correlation between the preoperative FEV1% and the predicted value of FEV1 in all cases. A weak but negative correlation (r=-0.2491) was found between them. Furthermore, in the FEV1% <50% group, the actual measurement value of FEV1 three months after the lobectomy was 253.9 mL larger than the predicted value and was 146.6 mL, 124.8 mL, and 70.4 mL in the FEV1 ≥50% but <60%, FEV1 ≥60% but <70%, and FEV1 ≥70% groups, respectively.
Conclusion
Although this method is convenient and useful in predicting the postoperative respiratory function, it tends to be generally underestimated, especially in patients with a significant ventilatory defect. These results suggest that it is necessary to be careful not to indicate an operable patient as being inoperable on the basis of the predicted FEV1.
