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Kohei Ando
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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): Kohei Ando
- 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.
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P2.10 - Prevention and Tobacco Control (ID 176)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Prevention and Tobacco Control
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.10-12 - Clinicopathological Analysis of the Lung Cancer Patients Who Have History of Asbestos Exposure (Now Available) (ID 437)
10:15 - 18:15 | Author(s): Kohei Ando
- Abstract
Background
Because of the delayed cessation of the asbestos use in industry, the malignant pleural mesothelioma patients are increasing in Japan. Simultaneously, lung cancer patients, who have history of asbestos exposure, is increasing in our hospital.
Method
We analyzed the characteristics of the lung cancer with the history of asbestos exposure. This study enrolled 1216 patients operated on in our department with a diagnosis of lung cancer since January 2003 to March 2018. Among them, 153 patients (12.6%) had the history of asbestos exposure.
Result
The patients were 145 men and 8 women, the age were 47 to 83 (mean 70) years old, shipyard workers were 22 men. 64 patients pointed out by the regular medical checkup, 61 were in the middle of detailed examination for other disease, 10 had hemoptysis, and 9 patients were suffering from cough. The affected sites were right 92, left 61.
The operative procedures were pneumonectomy 2, lobectomy 116, segmentectomy 8 and wedge resection 21. Postoperative complications were 49 episodes in total, such as bronchopleural fistula, pneumonia, ALI. 30 days mortality was 3cases (0.02%).
The histology were adenocarcinoma 87, Squamous cell carcinoma 49, adenosquamous cell carcinoma 5, small cell carcinoma 4, Large cell carcinoma 2, and LCNEC 4. The postsurgical stage (UICC ver,6, UICCver.7) were StageⅠA(33%,33%),ⅠB(29%,33%),ⅡA (7.8%,5.8%),ⅡB(9.8%,8.1%),ⅢA(3.9%,17.4%),ⅢB(5.9%,0%),Ⅳ(2.0%,1.2%), respectively. Over all 5 years survival rate was 62.1%.
Asbestos bodies count (by Smith method) were analyzed for 51 cases. The numbers were 3 to 718041 AB/g dry lung.
Conclusion
The characteristics of the lung cancer patients who have history of asbestos exposure were not unique, and no very special issues, in the aspects of symptom, histology and prognosis.
