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Hiroyasu Koga
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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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EP1.01-100 - Evaluation of the Clinicopathological Features of Patients in Whom Residual Carcinoma in Bronchial Stump After Surgery for Lung Cancer (Now Available) (ID 372)
08:00 - 18:00 | Author(s): Hiroyasu Koga
- Abstract
Background
Operation for lung cancer should be carried out with no residual carcinoma at bronchial stump. Rarely, we encounter unexpected microscopic residual carcinoma at surgical bronchial stump after surgery. Additional therapy for these patients is still controversial.
Method
From January, 2008 to December, 2018, 812 consecutive patients with non-small lung cancer underwent surgery (99 of segmentectomy, 694 of lobectomy, and 19 of pneumonectomy) in our institution. Among them, there were 7 cases (0.9%) which had bronchial stump with residual cancer cells. We investigated the clinicopathological characteristics and outcomes of these patients retrospectively.
Result
The procedures for the 7 cases consist of 5 lobectomy, 1 segmentectomy, and 1 pneumonectomy. In 3 cases, frozen diagnosis were done and in 2 of 3 cases additional resection were done. Histologically, there were 4 case of adenocarcinomas and 2 of squamous cell carcinomas, and 1 of adenosquamous cell carcinoma. 3 cases were stage ⅢB(pT4N2M0, pT3N2M0), and 3 cases were ⅢA (pT2bN2M0, pT4N1M0), 1 case was stage ⅡB (pT1bN1M0) respectively. All cases had lymphatic invasion microscopically.
6 cases developed recurrence or distant metastasis. 2 had local recurrence at bronchial stump and 4 had distant metastasis (1 was in brain, 1 was at lymph nodes, 1 was at vertebrae, 1 was at bilateral lungs).
5 cases were received postoperative additional therapies. 4 cases were received cytotoxic chemotherapy only, and another case was recieved cytotoxic chemotherapy and TKI. None of them were received radiotherapy for bronchial stump. 5 cases passed away because of cancer progression and 1 case was because chronic heart failier. Another case is alive with lung metastases taking TKI therapy.
In all cases, preoperative CT scan didn’t show bronchial wall thickning, and preoperative bronchoscopic findings showed normal bronchial mucosa.
Conclusion
In surgical cases of non-small cell lung cancer, 1.2% had microscopic residual cancer at surgical bronchial stump. Our study revealed that such cases tended to have a relapse as distant metastasis rather than local recurrence. Preoperative evaluation whether bronchial invasion exists or not is difficult and post-operative additional treatment strategy is still uncertain. In postoperative follow-up, systemic survey for not only local region but distant organs is necessary.
