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Kentaroh Miyoshi



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    EP1.18 - Treatment of Locoregional Disease - NSCLC (ID 208)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Treatment of Locoregional Disease - NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.18-08 - Pulmonary Lobectomy and Completion Pneumonectomy for Ipsilateral Lung Cancer After Radical Resection (Now Available) (ID 1218)

      08:00 - 18:00  |  Author(s): Kentaroh Miyoshi

      • Abstract
      • Slides

      Background

      Ipsilateral reoperation such as lobectomy and completion pneumonectomy after radical resection of lung cancer is a high-risk operation. We evaluated outcomes after these operations in our hospital.

      Method

      We retrospectively reviewed the records of 27 patients who underwent ipsilateral lobectomy or completion lobectomy for new primary lung cancer or recurrence after pulmonary lobectomy or bi-lobectomy between 1998 and 2017.

      Result

      9 patients underwent completion lobectomy, of which 4 were right and 5 were left, and 18 patients underwent lobectomy. Mean operative time was 308.7±27.4 minutes, and mean blood loss was 706.9±254.3mL. Blood loss was significantly higher in completion pneumonectomy patients as compared to lobectomy patients, whereas operative time was not different between the operations. There was no perioperative mortality, but intraoperative complications were seen in 4 cases (14.8%), which were 2 pulmonary artery injury, superior venous cava injury and azygos vein injury. Perioperative morbidity was seen in 8 cases (29.6%), and postoperative bronchopleural fistula occurred in one case. Fourteen patients had Pathological stage IA disease, 6 had IB, and 5 stage II or over. As clinical outcome, 5-year overall survival rate was 71.1%.

      Conclusion

      Pulmonary lobectomy or completion pneumonectomy for ipsilateral lung cancer after radical resection were performed in 27 patients without perioperative mortality. Our results strongly suggests that this strategy is a meaningful option for new or recurrent ipsilateral lung cancer.

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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-82 - Lung Cancer in Lung Transplant Recipients (Now Available) (ID 2334)

      10:15 - 18:15  |  Author(s): Kentaroh Miyoshi

      • Abstract
      • Slides

      Background

      Long-term immunosuppression is considered to increase the chance of developing malignancy, which is one of the leading causes of death after organ transplantation. Lung cancer in lung transplant recipients can originate from de-novo occurrence, transplanted donor’s lung and progression/recurrence of the recipient’s lung cancer. We conducted a survey of lung cancer in lung transplant recipients in our institution and report the case series.

      Method

      All 189 recipients who underwent lung transplantation (97 brain-dead donor lung transplantation, 90 living donor lobar lung transplantation, 2 hybrid lung transplantation) since October 1998 until December 2018 at Okayama University Hospital were retrospectively reviewed.

      Result

      Lung cancer was diagnosed in 4/189 (2.1%) of 16/189 (8.5%) all malignant diseases, in lung transplant recipients with a median follow-up of 4.5 years. Whereas de novo lung cancer occurred in one patient, patient-baring lung cancer was histologically detected in resected lung in three patients, leading to progression after transplantation in the two recipients. One recipient who had a previous history of lung cancer with over 5-year disease free period, experienced no recurrence afterword. All three recipients who had advanced lung cancer died relatively early from the diagnosis of lung cancer, regardless of cancer treatment.

      Lung cancer in lung transplant recipients could be difficult to detect by radiological screening and biopsy due to severely deteriorated lung condition, especially in idiopathic interstitial pneumonitis. Additionally, recipients with advanced lung cancer seem to have poor prognosis.

      Case Underlying disease Occurrence LTx - Lung cancer Degree of progression Treatment/Prognosis
      #1 LAM De novo 10 years Chest wall invasion Right pneumonectomy (10 months)chemotherapy (9 months)death
      #2 IIP Resected recipient’s lung 15 months Mediastinal lymph-nodes Lymph-node resection (10 months) death
      #3 IIP Resected recipient’s lung 3 months Pleural Dissemination chemotherapy (6 months)death
      #4 BO Resected recipient’s lung nil nil

      nil

      LAM: lymphoangioleiomyomatosis IIP: idiopathic interstitial pneumonitis BO: bronchiolitis obliterans LTx: lung transplant

      Conclusion

      Lung cancer in lung recipients should be screened carefully ever since listing for transplantation.

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